| NPI | 1811641863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALESA NICOLE LEACH Speech Pathologist 662-549-1465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2022-02-08 |