| NPI | 1861279952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA VOGELSONG Owner/Provider 904-521-0568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225100000X Physical Therapist | |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2023-09-12 |