| NPI | 1568614642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA OTTO Owner/Director 904-652-5408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA5968) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL sa9598) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2015-03-23 |