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1992365290
JESSICA N VANDERWAY
BLOOMINGTON, IL
NPI
1992365290
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: IL 242.005334)
Enumeration Date
2019-06-18
Last Update Date
2019-06-18
Business Address
JESSICA N VANDERWAY M.S. CF-SLP
1925 S MAIN ST
BLOOMINGTON, IL 61704-7313
Phone number: 515-978-6755
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Mailing Address
JESSICA N VANDERWAY M.S. CF-SLP
707 GOLFCREST RD S APT 4
NORMAL, IL 61761-6044
Phone number: 630-890-9349
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