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Organization
THE SPEECH MENTOR LLC
Active
Organization
THE SPEECH MENTOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREASYRI WILLIAMS M.A.,CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(248) 747-1132
Entity
Organization
Contact information
Practice address
6100 S WOODLAWN AVE APT G, CHICAGO, IL 60637-6063
(248) 747-1132
(773) 599-9475
Mailing address
6100 S WOODLAWN AVE APT G, CHICAGO, IL 60637-4092
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146013575
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11444501172
BLUE CROSS BLUE SHEILD
IL
05
—
1144501172
—
IL
Enumeration date
08/16/2017
Last updated
08/16/2017
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