Individual
IYONTAE S MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CF-SLP
Contact information
Practice address
6820 IL-162, MARYVILLE, IL 62062
(618) 288-5436
Mailing address
100 CALYPSO DR, BELLEVILLE, IL 62221-4392
(618) 615-9378
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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