| NPI | 1558044487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY LYNN LEPAGE Speech Language Pathologist 313-687-4972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-15 |