Individual
JOANN L. MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2925 28TH AVENUE A, MOLINE, IL 61265-6924
(309) 762-7974
Mailing address
3571 8TH ST, MOLINE, IL 61265-7157
(309) 236-3614
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.004703
IL
Other
Enumeration date
12/04/2007
Last updated
08/01/2014
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