| NPI | 1821430224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE TRAVERS Speech Language Pathologist 904-318-2995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 4978) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2013-07-25 |