| NPI | 1942735246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACE JAHNER Owner 623-980-4164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |