| NPI | 1619598000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRESA KEYONNA PHILLIPS Speech Language Pathologist/ Owner 281-662-5107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-04-27 |