| NPI | 1750896932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN D BROCKMAN-HAWE Business Owner 530-318-8306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MD 14051323) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60514608) |
| Enumeration Date | 2017-12-09 |
| Last Update Date | 2018-01-13 |