| NPI | 1932926268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRA MEDINA TIENCKEN Owner/Director Of Clinical Srvices 862-812-1552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2024-09-26 |
| Last Update Date | 2024-09-26 |