NPI | 1851950414 |
---|---|
Entity Type | Organization |
Authorized Contact | SHELLY HERBOTH Owner 618-322-5493 |
Organization Subpart ? | No |
Primary Taxonomy | 222Q00000X Developmental Therapist |
Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
Enumeration Date | 2019-06-07 |
Last Update Date | 2019-06-07 |