| NPI | 1578251542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA HOGGARD Member 870-613-0793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 261QH0700X Clinic/Center, Hearing and Speech | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2023-04-27 |