Individual
JENNIFER EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
100 E. MAXWELL ST., NEWTON, IL 62448
(618) 783-8464
Mailing address
100 E. MAXWELL ST., NEWTON, IL 62448
(618) 783-8464
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.004814
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1268707
ILLINOIS SPEECH LANGUAGE HEARING ASSOCIATION
IL
01
—
1427725
ASHA
—
01
—
239258
IEIN
IL
01
—
242.004814
STATE OF IL
IL
Enumeration date
08/21/2018
Last updated
08/21/2018
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