| NPI | 1861147589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRA DEE PHILLIPS Co Owner 336-260-0065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-02-22 |