| NPI | 1013634989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN BANASIAK Speech Language Pathologist 815-315-2405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-10-21 |
| Last Update Date | 2022-10-21 |