| NPI | 1790074714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN DENISE WINNEY Assistant Director 2168-490-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2011-03-30 |