| NPI | 1700474889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LEANN WIDMAN Speech Language Pathologist 561-847-1108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2021-01-05 |