| NPI | 1700499282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE BEARDEN Speech Language Pathologist 831-643-5973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2021-11-30 |