| NPI | 1578646865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON LYNN TUCKER Executive Director 704-523-8027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2012-10-16 |