| NPI | 1780350934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREANNA VICTORIA CALKINS Speech Language Pathologist 386-490-6768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2021-08-18 |