| NPI | 1912696402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGAN COTTER Owner 870-368-4586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2024-03-29 |