Individual
JENNIFER OSABEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6900 W MAIN ST, MARYVILLE, IL 62062-6634
(618) 346-6261
Mailing address
6900 W MAIN ST, MARYVILLE, IL 62062-6634
(618) 346-6261
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.006480
IL
Other
Enumeration date
12/07/2017
Last updated
12/07/2017
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