| NPI | 1861201600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ABNEY JACOBS Auhtorized Official, Owner, Provide 270-799-0779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |