Individual
ANGELA SUDHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TAYLOR
Contact information
Practice address
3393 VENHAUS RD, TRENTON, IL 62293-3220
(618) 741-7226
Mailing address
3393 VENHAUS RD, TRENTON, IL 62293-3220
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146009797
IL
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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