Individual
JULIA DEBRA DETTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 N CLYBOURN AVE UNIT C105, CHICAGO, IL 60610-2295
(312) 242-1665
Mailing address
1457 N HALSTED ST APT 1102, CHICAGO, IL 60642-2640
(916) 320-0577
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.016289
IL
Other
Enumeration date
12/05/2021
Last updated
12/05/2021
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