| NPI | 1740658558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE HERNDON Office Manager 229-244-5750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA 1930) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 9005) |
| 225X00000X Occupational Therapist (Licence: GA 6136) | |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |