| NPI | 1821490277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA WAGNER President 570-573-0258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL 11554) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |