| NPI | 1659250090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPHINE SACK Speech Language Pathologist 309-749-8865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2025-08-29 |
| Last Update Date | 2025-08-29 |