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Individual

ELISE VALERIE O'BRIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A. CCC-SLP

Contact information

Practice address
735 CHICAGO AVE, APT 232, EVANSTON, IL 60202-2373
(312) 493-4716
Mailing address
735 CHICAGO AVE, APT 232, EVANSTON, IL 60202-2373
(312) 493-4716

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146004935
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
146004935
SPEECH LANGUAGE PATHOLOGIST LICENSE
IL
Enumeration date
05/11/2012
Last updated
01/19/2021
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