| NPI | 1649933250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRAL LATADY Speech Language Pathologist 228-219-4793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2021-11-12 |