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Individual

BRYNN ERIN BASINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
3905 W ERNESTINE DR, SUITE B, MARION, IL 62959-5800
(618) 993-6237
(618) 997-3529
Mailing address
3905 W ERNESTINE DR, SUITE B, MARION, IL 62959-5800
(618) 993-6237
(618) 997-3529

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146010929
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
146010929
IL LICENSE
IL
Enumeration date
10/17/2012
Last updated
10/17/2012
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