NPI | 1972869550 |
---|---|
Entity Type | Organization |
Authorized Contact | LORA CAMPBELL President/ Slp 815-505-4463 |
Organization Subpart ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: IL 146.005242) |
Enumeration Date | 2012-04-08 |
Last Update Date | 2025-02-25 |