| NPI | 1578314753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA TERRELL Speech Language Pathologist 631-560-9118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-06-28 |