| NPI | 1982077194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH WASNICK Billing Specialist 800-844-1232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 1831348028) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 1821203100) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2015-11-10 |