| NPI | 1639473663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MARTIN Owner 815-603-8632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-01-05 |