Individual
MS. DIANE S CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
504 PIKE DR W, HIGHLAND, IL 62249-1778
(618) 654-2256
Mailing address
504 PIKE DR W, HIGHLAND, IL 62249-1778
(618) 654-2256
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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