| NPI | 1790400554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BURGANDY HENDERSON Speech Language Pathologist/Owner 217-737-4331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |