| NPI | 1669043667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY SISTAK Co Director 602-345-1785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 2355S0801X Specialist/Technologist Speech-Language Assistant |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2024-06-28 |