Woodstock Stuttering Specialist

NPI 1063822260 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1063822260
Enumeration Date 04/28/2014
Last Updated 04/28/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name KEVIN KEVIN
Position SLP/SOLE PROPRIETOR
Phone (815) 308-5477
Fax (815) 334-1136
Practice Location
110 WASHINGTON ST
WOODSTOCK IL, 60098-3305, US
Phone (815) 308-5477
Fax (815) 334-1136
Business Location
110 WASHINGTON ST
WOODSTOCK IL, 60098-3305, US
Phone (815) 308-5477
Fax (815) 334-1136
Toxanomy
Taxonomy Code 235Z00000X
License State Illinois
License Number 146.006432
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According to our database, Woodstock Stuttering Specialist NPI is 1063822260, taxonomy code is 235Z00000X and license number is 146.006432, license state is located at Illinois. Woodstock Stuttering Specialist physically located at 110 Washington St, Woodstock IL, 60098-3305. NPI Number 1033115704 has the healthcare provider type.

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1063822260 NPI number is provided on an as is basis without warranty of any kind. 1063822260 is maintained by the National Plan & Provider Enumeration System. The contents of Woodstock Stuttering Specialist are for informational purposes only.