| NPI | 1942620489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH A DEITER Speech Language Pathologist 224-409-7150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2017-09-20 |