| NPI | 1740355262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM PETERS Office Manager 919-847-6773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2013-06-03 |