Individual
COURTNEY N MAISEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
623 HAMACHER ST, WATERLOO, IL 62298-1786
(618) 939-3488
Mailing address
117 SANDSTONE DR, RED BUD, IL 62278-2346
(618) 716-5541
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.006766
IL
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
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