| NPI | 1952080475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE LARSEN Speech Language Pathologist 562-841-2877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-08-28 |