| NPI | 1780350025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY KOMISARUK President 321-388-2924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 261QH0700X Clinic/Center Hearing and Speech |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |