| NPI | 1568940823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP GUILLORY Owner 505-835-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM 5026) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |