| NPI | 1902472996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN WILDERMUTH Owner 941-485-0121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 224Z00000X Occupational Therapy Assistant | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-01 |