| NPI | 1881329019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIMIE GANT Speech Language Pathologist 813-586-0802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2023-07-28 |