| NPI | 1982943353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA C CLARK Director Of Therapy 800-994-1031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 106104) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 225X00000X Occupational Therapist | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2016-03-08 |