| NPI | 1679260012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN WATSON Owner 346-391-6389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-05-19 |