Individual
JONI MARIE LIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1000 E. 6TH STREET, PANA, IL 62557
(216) 756-2217
Mailing address
211 SAWGRASS DRIVE, APARTMENT 4, CHATHAM, IL 62629
(618) 553-3788
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.013560
IL
235Z00000X
Speech-Language Pathologist
242.003871
IL
Other
Enumeration date
06/01/2016
Last updated
12/03/2018
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