| NPI | 1720114788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET HANSON Executive Director 618-529-5944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |