| NPI | 1962196550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEE MILLICENT NEIDIGH Owner 469-301-5495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-06 |