| NPI | 1922709435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSSA R SHAH Owner 920-284-2278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2025-08-19 |