| NPI | 1982620183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER STEPHENS Owner/Speech Language Pathologist 706-364-6172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 025171) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: GA 025171) |
| 235Z00000X Speech-Language Pathologist, (Licence: GA 025171) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |