STEPHANIE RAE GREEN

MOUNT VERNON, IL
NPI1447766290
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: IL  146003822)
Enumeration Date2017-12-15
Last Update Date2017-12-15
Business Address
STEPHANIE RAE GREEN
401 N 30TH ST
MOUNT VERNON, IL 62864-2355
Phone number: 618-244-8068
Mailing Address
STEPHANIE RAE GREEN
14785 N PUMP HOUSE LN
MOUNT VERNON, IL 62864-8750
Phone number: 618-244-8068
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