| NPI | 1730951187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MAYFIELD Intermim Clinical Director 346-550-1055 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 133N00000X Nutritionist |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2023-10-27 |