| NPI | 1669039277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN L ELLSWORTH Speech Language Pathologist 616-443-1699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |