Individual
MRS. AUDREY NATASHA MIGHTY-HARMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
9923 RIDGELAND AVE, SUITE 131, CHICAGO RIDGE, IL 60415-1262
(773) 412-9824
(773) 445-0350
Mailing address
9354 S BISHOP ST, 2ND FLOOR, CHICAGO, IL 60620-5136
(773) 445-0540
(773) 445-0350
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146-005187
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635357
BLUE CROSS BLUE SHIELD
IL
05
—
100044415
—
IL
Enumeration date
03/13/2007
Last updated
07/08/2007
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