| NPI | 1609130822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L BACON Owner/Speech Pathologist 337-344-5407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: LA 5135) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2013-02-25 |