| NPI | 1558831008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AESHIA JACKSON President 910-315-4487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2020-01-08 |