Individual
CORLIS BERCHIOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5510 NICHOLS DR, ROCKFORD, IL 61108-2333
(815) 289-4908
Mailing address
5510 NICHOLS DR, ROCKFORD, IL 61108-2333
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.003072
IL
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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