| NPI | 1558017368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN LOUIS DICARLO Credentialing Team Lead 855-324-0885 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2022-03-02 |