| NPI | 1750983292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE E LIGHTCAP Speech Language Pathologist 719-251-1920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2020-11-10 |