Individual
MRS. EMILY RENEE TOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
101 S WEST ST, WARRENSBURG, IL 62573-9680
(217) 672-3089
Mailing address
101 S WEST ST, WARRENSBURG, IL 62573-9680
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.013057
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146.013057
—
IL
Enumeration date
10/19/2017
Last updated
10/19/2017
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