Organization
DAMARIS MILTENBERGER LANGUAGE & LEARNING CENTER, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAMARIS MILTENBERGER (OWNER)
(618) 351-1279
Entity
Organization
Contact information
Practice address
301 S. WALL ST., SUITE B, CARBONDALE, IL 62902
(618) 351-1279
(618) 351-6369
Mailing address
PO BOX 3295, CARBONDALE, IL 62902-3295
(618) 351-1279
(618) 351-6369
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146002025
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405587167001
—
IL
Enumeration date
01/17/2007
Last updated
07/14/2008
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