Individual
JESSICA ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 MARK FRANKLIN DR, BENTON, IL 62812-2049
(618) 439-3500
Mailing address
1310 MARK FRANKLIN DR, BENTON, IL 62812-2049
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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