| NPI | 1891947537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA GILLMER Speech Language Pathologist 904-910-2296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist (Licence: FL OT9446) | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, (Licence: FL SA8670) | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2022-11-03 |