| NPI | 1598310500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE MARIA GLASS BISHOP Speech Language Pathologist 270-678-5417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |