Individual
GRACE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., SLP
Contact information
Practice address
9620 WILLOW LN, MOKENA, IL 60448-9318
(815) 763-1407
Mailing address
1406 ADDLEMAN ST, JOLIET, IL 60431-2702
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242007837
IL
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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