Individual
ELIZABETH PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
2506 N CLARK ST, SUITE 158, CHICAGO, IL 60614-1848
(312) 278-0022
Mailing address
2506 N CLARK ST, SUITE 158, CHICAGO, IL 60614-1848
(312) 278-0022
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146012525
IL
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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