Individual
MR. EMMA CRISTINE TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1619 W. FREDONIA AVE, PEORIA, IL 61606
(309) 672-6569
Mailing address
1619 W. FREDONIA AVE, PEORIA, IL 61606
(309) 672-6569
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146013470
IL
Other
Enumeration date
10/18/2018
Last updated
10/18/2018
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