Individual
JAYME PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1021 13TH ST, CHARLESTON, IL 61920-2906
(217) 549-1000
Mailing address
405 COUNTY ROAD 425 N, SIGEL, IL 62462-2010
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146014560
IL
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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