| NPI | 1689433138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON JAMES EDWIN MCGOVERN Owner 570-905-4334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics |
| 225XP0200X Occupational Therapist Pediatrics | |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-04-17 |