| NPI | 1639761364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL VIGIL Owner 505-818-7278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center Hearing and Speech |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2023-03-29 |