| NPI | 1578055158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVINA WALLACE CEO 813-215-6275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2021-08-06 |