| NPI | 1558676510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA PUCKETT Speech Pathologist 219-363-2832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2010-08-15 |
| Last Update Date | 2010-08-15 |