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Individual

MRS. ANISSA R CONWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.-CCC/SLP

Contact information

Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 381-7721
Mailing address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 381-7721

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.007952
IL
235Z00000X
Speech-Language Pathologist
2907-154
WI

Other

Enumeration date
03/01/2010
Last updated
03/01/2010
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