| NPI | 1659852879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY MARIE SMITH Owner 251-209-1802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AL 3719) |
| Enumeration Date | 2018-08-25 |
| Last Update Date | 2019-09-11 |