| NPI | 1548967912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAN LUONG Owner 316-519-1795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-05-10 |