| NPI | 1912544156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDILBERTO MONTENEGRO Director 678-898-2055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2019-12-06 |