Individual
BONNIE JO LEVELING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC/SLP
Contact information
Practice address
87 GRIMMIG RD, SWANSEA, IL 62226-2010
(618) 257-9201
Mailing address
87 GRIMMIG RD, SWANSEA, IL 62226-2010
(618) 257-9201
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146003513
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467590166
—
IL
Enumeration date
11/08/2017
Last updated
03/17/2018
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