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1720302938
TIFFANY TIEASHA BURKETT
CHICAGO, IL
NPI
1720302938
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: IL 146.0008425)
Enumeration Date
2010-03-16
Last Update Date
2010-03-16
Business Address
-- TIFFANY TIEASHA BURKETT
3402 W LEXINGTON ST
CHICAGO, IL 60624-4132
Phone number: 773-722-0801
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Mailing Address
-- TIFFANY TIEASHA BURKETT
3402 W LEXINGTON ST
CHICAGO, IL 60624-4132
Phone number:
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