| NPI | 1982436879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREWINE OGBASELASE Speech Language Pathologist 267-314-7501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |