Individual
ASHLI SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8600 US HIGHWAY 14, STE 108, CRYSTAL LAKE, IL 60012-2700
(815) 403-0485
(815) 527-6037
Mailing address
5704 WONDER WOODS DR, WONDER LAKE, IL 60097-9114
(815) 403-0485
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146012344
IL
Other
Enumeration date
01/03/2016
Last updated
09/29/2017
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