| NPI | 1639832595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA BUTLER Speech Language Pathologist 336-254-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2021-10-20 |