NPI | 1538750880 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMIE LEA FORTHMAN Credentialing Manager 270-557-6396 |
Organization Subpart ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
Enumeration Date | 2021-01-29 |
Last Update Date | 2021-03-31 |