| NPI | 1720341647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER LYNN BALOG Slp Ccc/Owner 734-658-6150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101000029) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2012-06-18 |