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Individual

GYPSYLEE BUCHHOLZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS- CCC

Contact information

Practice address
780 SHORELINE DR, AURORA, IL 60504-6192
(630) 529-6211
Mailing address
2256 ABBEYWOOD DR APT C, LISLE, IL 60532-6822
(630) 730-0584

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2350905
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30117580
IL
Enumeration date
11/13/2017
Last updated
10/27/2022
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