| NPI | 1700428539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SCHAEFER Speech Language Pathologist 618-741-7036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2019-10-14 |