| NPI | 1699644377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY FAIRLEY Occupational Therapist 331-643-3771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2025-11-01 |
| Last Update Date | 2025-11-01 |