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1912410663
ANNELISE THIFAULT
ROCKFORD, IL
NPI
1912410663
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: IL 242.004652)
Enumeration Date
2017-11-15
Last Update Date
2017-11-15
Business Address
ANNELISE THIFAULT
2525 OHIO PKWY
ROCKFORD, IL 61108-7517
Phone number: 815-229-2800
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Mailing Address
ANNELISE THIFAULT
273 CORDIAL DR
BRIDGEVILLE, PA 15017-1133
Phone number:
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