| NPI | 1922605989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHTYN MOUTON Speech Language Patholgist 850-461-5676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |