| NPI | 1639624836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE C BOYLE CEO 267-400-6816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL011432) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |