NPI | 1871154948 |
---|---|
Entity Type | Organization |
Authorized Contact | HEATHER BRYAN AYDELOTTE Owner 302-883-4516 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
Enumeration Date | 2019-06-27 |
Last Update Date | 2022-02-08 |