| NPI | 1871231787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLEE POTTER Owner 904-505-0847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-06-26 |