| NPI | 1578282265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE VANGESSEL Speech Language Pathologist 260-226-6135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2023-10-13 |