| NPI | 1679515985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHELLE CLARK Owner 706-592-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2010-05-24 |