| NPI | 1598036030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE L FREDERICK Slp 870-270-7963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: AR SP#3079) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2023-12-05 |