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Organization
SELF TALK THERAPY SERVICES PC
Active
Organization
SELF TALK THERAPY SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLI J SELF M.A. CCC-SLP (PRESIDENT/SPEECH-LANGUAGE PATH.)
(815) 403-0485
Entity
Organization
Contact information
Practice address
8600 US HIGHWAY 14, CRYSTAL LAKE, IL 60012-2706
(815) 403-0485
(815) 277-1242
Mailing address
5704 WONDER WOODS DR, WONDER LAKE, IL 60097-9114
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13683650
CAQH
IL
Enumeration date
08/09/2016
Last updated
09/15/2023
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