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Active
Organization subpart
No

Provider details

NPI number
Authorized official
SENTA EMMONS CCC-SLP/L (SPEECH LANGUAGE PATHOLOGIST)
(708) 869-0192
Entity
Organization

Contact information

Practice address
2435 DAVISSON ST, RIVER GROVE, IL 60171-1716
(630) 234-1092
Mailing address
2435 DAVISSON ST, RIVER GROVE, IL 60171-1716
(630) 234-1092

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146010961
IL

Other

Enumeration date
02/27/2018
Last updated
02/27/2018
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