| NPI | 1790410553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAUNCEY A MALONE Speech Language Pathologist 229-288-7894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-07-17 |
| Last Update Date | 2022-07-17 |