Individual
ANGELA LAGOCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4114 W HOLLOW TRACE DR, PEORIA, IL 61615-2421
(309) 370-4512
Mailing address
4114 W HOLLOW TRACE DR, PEORIA, IL 61615-2421
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146007546
IL
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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