| NPI | 1689201329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE GAGNON Owner 917-751-8706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2021-02-22 |