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Organization
CENTRAL ILLINOIS SPEECH THERAPY
Active
Organization
CENTRAL ILLINOIS SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN LARA DUDEK-BRANNAN ED.D. CCC-SLP/L (SPEECH LANGUAGE PATHOLOGIST)
(309) 212-4862
Entity
Organization
Contact information
Practice address
4 HOLDER WAY, BLOOMINGTON, IL 61704-8152
(309) 212-4862
Mailing address
4 HOLDER WAY, BLOOMINGTON, IL 61704-8152
(309) 212-4862
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/02/2015
Last updated
11/02/2015
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