Individual
ELIZABETH FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC SLP
Contact information
Practice address
1136 KRISTIN DR, LIBERTYVILLE, IL 60048-1281
(847) 508-1098
Mailing address
1136 KRISTIN DR, LIBERTYVILLE, IL 60048-1281
(847) 508-1098
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146010183
IL
235Z00000X
Speech-Language Pathologist
24201157
IL
Other
Enumeration date
04/05/2010
Last updated
12/11/2023
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