| NPI | 1730821240 |
|---|---|
| Former Legal Business Name | UNLOCKED POTENTIAL |
| Entity Type | Organization |
| Authorized Contact | MADLEN PENN Owner 907-444-5005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-04-13 |