KELLY ANN DIEKEMPER

O FALLON, IL
NPI1285992560
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: IL  146.011505)
Additional Taxonomies235Z00000X Speech-Language Pathologist,
(Licence: IL  242.002236)
Enumeration Date2012-04-24
Last Update Date2013-03-18
Business Address
-- KELLY ANN DIEKEMPER
634 N MAIN ST STE 3
O FALLON, IL 62269-3746
Phone number: 618-632-4222
Mailing Address
-- KELLY ANN DIEKEMPER
740 N HARRISON ST
TRENTON, IL 62293-1072
Phone number: 618-444-2984