Individual
MS. CHANCY NICOLE RODEGHERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1416 MAINE ST, QUINCY, IL 62301-4261
(217) 223-8700
Mailing address
10960 SCOTT PL, HANNIBAL, MO 63401-7387
(573) 822-5732
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146012060
IL
235Z00000X
Speech-Language Pathologist
2006015397
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467618906
—
MO
Enumeration date
12/10/2007
Last updated
07/21/2022
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