| NPI | 1952533002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY GAULT Owner 678-571-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA2869) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-08-21 |