| NPI | 1497503791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE GRACE DETLOFF Director Of Operations 815-751-4364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2024-05-10 |
| Last Update Date | 2024-05-10 |