| NPI | 1598222358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE BURNETT Speech Language Pathologist 321-917-0297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |