| NPI | 1629762752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARIETTE FULTON Speech Pathologist 415-497-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-06-02 |