| NPI | 1891452017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALA WAGNER Speech Language Pathologist/Owner 810-887-1363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2021-11-22 |