| NPI | 1962798975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANDRIA SEALS GREEN Executive Director 866-752-0899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech (Licence: CT 003069) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 235Z00000X Speech-Language Pathologist, | |
| 251C00000X | |
| 251S00000X Community/Behavioral Health | |
| 261QA3000X Clinic/Center, Augmentative Communication (Licence: CT 003069) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-06-28 |