| NPI | 1881468130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIONA VERONICA GOODELL Authorized Representative 386-481-0590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-11-08 |