| NPI | 1861124117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA P ANDERSON Speech Language Pathologist 704-530-0699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-06-27 |