| NPI | 1609691450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY ASTON CFO 870-336-0238 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics |
| 225XP0200X Occupational Therapist Pediatrics | |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |