| NPI | 1205485489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER DIANE METAXAS Speech Language Pathologist 847-852-0928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2023-08-29 |