BASHA ONTIVEROS

BLOOMINGTON, IL
NPI1629083423
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: IL  146007682)
Enumeration Date2006-07-30
Last Update Date2022-08-22
Business Address
BASHA ONTIVEROS M.S., CCC-SLP
2416 E WASHINGTON ST STE C5
BLOOMINGTON, IL 61704-1629
Phone number: 913-730-5925
Mailing Address
BASHA ONTIVEROS M.S., CCC-SLP
207 IMPERIAL DR
BLOOMINGTON, IL 61701-2029
Phone number: 309-830-5925
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