| NPI | 1821686379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELLERS A SHANTE Speech Language Pathologist 904-210-2885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-05-11 |