| NPI | 1659065282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MARIE BOARDMAN JENSEN Speech Language Pathologist 530-219-7853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-06 |