| NPI | 1790421121 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JENNY VINCENT Speech Pathologist / Owner 618-697-4017  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, | 
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation | 
| Enumeration Date | 2022-05-09 | 
| Last Update Date | 2024-02-06 |