| NPI | 1124700240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANIE TYBURCZY Speech Language Pathologist 815-919-6155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-07 |