Individual
SHAWNA GRACE STADTHERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2925 MANCHESTER DR, MONTGOMERY, IL 60538-4063
(630) 338-2263
Mailing address
2925 MANCHESTER DR, MONTGOMERY, IL 60538-4063
(630) 338-2263
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
217000414
IL
Other
Enumeration date
09/08/2019
Last updated
09/08/2019
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