Individual
ANNIE LIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22741 SASSAFRAS RD, HOYLETON, IL 62803-1324
(618) 322-6879
Mailing address
22741 SASSAFRAS RD, HOYLETON, IL 62803-1324
(618) 322-6879
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
02/07/2022
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