| NPI | 1962946152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY SQUIRES Owner 404-719-3991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP008235) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-09 |