| NPI | 1679071740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA VASTOLER Therapist 732-580-3539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: NJ 41YS00596800) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-24 |