| NPI | 1790143113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULISSA GAYLE IRACHETA CEO Owner 682-500-1958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2022-10-07 |