| NPI | 1962870774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA PENDLEY Owner 239-248-0458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA4153) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |