| NPI | 1699551101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENA LEIGH SOUTHERLAND Speech Language Pathologist 910-310-9479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 174N00000X Lactation Consultant, Non-RN | |
| Enumeration Date | 2023-08-31 |
| Last Update Date | 2025-07-31 |