| NPI | 1639634025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CORNELL Director 407-848-6912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106S00000X Behavior Technician | |
| 224Z00000X Occupational Therapy Assistant | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2019-02-10 |
| Last Update Date | 2019-02-10 |