| NPI | 1831339928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE D. LONG Owner 360-679-4211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL0003493) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2009-03-02 |