| NPI | 1184124042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN THERESA MANDRELLE Slp 847-322-1126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 3299-154) |
| Enumeration Date | 2018-02-17 |
| Last Update Date | 2018-02-17 |