| NPI | 1689421976 |
|---|---|
| Doing Business As | LO-GO-PAE-DICS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL LOPEZ Manager 725-255-5321 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-03 |