Individual
ANNA VIRGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP-L
Contact information
Practice address
2405 CHAMPAIGN AVE, MATTOON, IL 61938-2646
(217) 238-8800
Mailing address
2405 CHAMPAIGN AVE, MATTOON, IL 61938-2646
(217) 238-8800
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146011128
IL
Other
Enumeration date
12/06/2013
Last updated
12/06/2013
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