| NPI | 1851147532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KATHRYN THOMSEN Speech Language Pathologist 601-818-0415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-04-24 |