Individual
MRS. JENNIFER ILCONICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
146 VALLEYCREST DR, CECIL, PA 15321-1138
(419) 787-8678
Mailing address
146 VALLEYCREST DR, CECIL, PA 15321-1138
(419) 787-8678
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL008386
PA
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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