Individual
BRIDGET REAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N COLLEGE AVE, GENESEO, IL 61254-1091
(309) 944-6431
Mailing address
600 N COLLEGE AVE, GENESEO, IL 61254-1091
(309) 944-6431
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.005476
IL
Other
Enumeration date
07/02/2012
Last updated
08/09/2012
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