| NPI | 1780018424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA MARIE SHELLY Speech Language Pathologist 610-736-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2014-08-27 |