| NPI | 1689399941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA TRINA BRAVO Speech Language Pathologist 219-798-2655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2022-10-10 |