NPI | 1801137674 |
---|---|
Entity Type | Organization |
Authorized Contact | JACQUELINE MELISSA SUMNER DAVIS Owner 772-257-6962 |
Organization Subpart ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA12097) |
Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: FL SA12097) |
Enumeration Date | 2013-03-04 |
Last Update Date | 2019-09-26 |