Individual
JAMIE GARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
507 E ARMSTRONG AVE, PEORIA, IL 61603-3201
(309) 686-1177
(309) 686-7722
Mailing address
507 E ARMSTRONG AVE, PEORIA, IL 61603-3201
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242001673
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370686250001
—
IL
Enumeration date
08/01/2011
Last updated
08/01/2011
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