Individual
HENRIETTA BOUDROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 238-5939
Mailing address
1120 N LA SALLE DR APT 19M, CHICAGO, IL 60610-7613
(312) 217-5602
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146007085
IL
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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