| NPI | 1841054822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA FUNK Administrator 949-422-3609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant | |
| 224Z00000X Occupational Therapy Assistant | |
| Enumeration Date | 2024-02-09 |
| Last Update Date | 2024-02-09 |