| NPI | 1801963475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY RANDOLPH Speech Language Pathologist 910-599-6994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 5025) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2011-06-01 |