| NPI | 1649756214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL R HAWKS Speech Language Pathologist 307-399-4010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |