Individual
ELLEN KAY WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1202 N 223RD LN, PAYSON, IL 62360-2414
(217) 656-3590
Mailing address
1202 N 223RD LN, PAYSON, IL 62360-2414
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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