Individual
MISS JERICA RENEE PATEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
723 INSIGHT AVE STE 300, O FALLON, IL 62269-2193
(618) 607-0086
Mailing address
524 GLENDALE DR, TROY, IL 62294-1766
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146013718
IL
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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