Individual
BROOKE E LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS-SLP
Contact information
Practice address
924 S COMMERCIAL ST, HARRISBURG, IL 62946-2637
(618) 252-7171
Mailing address
924 S COMMERCIAL ST, HARRISBURG, IL 62946-2637
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.011298
IL
Other
Enumeration date
01/04/2012
Last updated
08/16/2012
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