| NPI | 1598185431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO SHACKELFORD Owner 270-202-3316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KY 1374) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-04-18 |