TARA S SAMPLE

NEW LENOX, IL
NPI1508909375
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: IL  146-006392)
Enumeration Date2007-02-14
Last Update Date2007-07-08
Business Address
Mrs. TARA S SAMPLE MHSCCCSLP L
346 ALANA DR
NEW LENOX, IL 60451-1784
Phone number: 815-462-0514
Mailing Address
Mrs. TARA S SAMPLE MHSCCCSLP L
1095 JAMES PASS
NEW LENOX, IL 60451-3148
Phone number: 815-483-8535