| NPI | 1639711104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAELYN MONTGOMERY Owner/Speech Language Pathologist 417-592-4585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2019-10-16 |