| NPI | 1811643612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ELIZABETH RUSSELL Speech Language Pathologist 916-715-6780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-03-01 |