| NPI | 1720717291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LANE Speech Language Pathologist 321-360-6775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2022-06-08 |