| NPI | 1982693743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA A HUMPHRESS Fiscal Officer 812-855-4156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2021-02-01 |