Individual
GEETHU SABU MAKIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1039 BLUEHERON WAY,, APT#3, BLOOMINGTON, IL 61704
(309) 750-5447
Mailing address
1039 BLUEHERON WAY,, APT#3, BLOOMINGTON, IL 61704
(309) 750-5447
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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