| NPI | 1649725763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE HERNDON Owner/Administrator 888-701-9216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2024-05-08 |