| NPI | 1497251797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA M POPE-JEFFERSON CEO 618-559-7105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146006150) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-05 |