| NPI | 1992473532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABBY HOEKSEMA Speech Language Pathologist 505-352-4076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-08-30 |