Individual
ASHLEY LYNN MORITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP/L
Contact information
Practice address
4950 ROUTE 173, POPLAR GROVE, IL 61065
(815) 765-2113
(815) 765-0003
Mailing address
9957 GRANGE HALL RD, BELVIDERE, IL 61008-8904
(847) 651-2470
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.011178
IL
Other
Enumeration date
03/30/2012
Last updated
07/03/2012
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