Organization
COVENANT CARE THERAPY LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VANESSA R. HALLOM MS. CCC-SLP/L (SPEECH PATHOLOGIST)
(773) 615-6433
Entity
Organization
Contact information
Practice address
1875 W 108TH PL, CHICAGO, IL 60643-3331
(773) 615-6433
Mailing address
1875 W 108TH PL, CHICAGO, IL 60643-3331
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/20/2007
Last updated
09/20/2007
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