Individual
KENYATTA SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STA
Contact information
Practice address
4515 N MILWAUKEE AVE, CHICAGO, IL 60630-3711
(773) 507-5507
Mailing address
4515 N MILWAUKEE AVE, CHICAGO, IL 60630
(773) 507-5507
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
217.000239
IL
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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