| NPI | 1780216119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA KETT Owner 520-330-6108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |