| NPI | 1598318974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA D WOODS Member/Speech Therapist 270-240-5051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2020-04-25 |