| NPI | 1851659825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ANDREW FULLER Owner 501-230-3916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: AR 1372) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2012-04-27 |