Individual
MS. JANE ANNE INNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1499 W MAIN ST, DECATUR, IL 62522-1909
(217) 362-3510
Mailing address
335 E CERRO GORDO ST, DECATUR, IL 62523-1013
(217) 362-3510
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01065451
IL
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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