| NPI | 1871150672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE JACKSON Speech Pathologist/Owner 334-477-3114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-05-28 |