| NPI | 1912653924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WILSON Co Owner 901-337-5863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-02-28 |