Individual
MRS. ELIZABETH MACKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP-L
Contact information
Practice address
128 WASHINGTON SQ, WASHINGTON, IL 61571-2657
(800) 773-1682
Mailing address
214 NORMAN DR, GROVELAND, IL 61535-9770
(309) 387-6975
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146000985
IL
Other
Enumeration date
05/02/2012
Last updated
05/02/2012
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