| NPI | 1902497340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY RENEE WILSON-LEWIS Clinical Owner 678-667-4650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |