| NPI | 1508310459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLI J SELF President/Speech Language Path. 815-403-0485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2023-09-15 |