Individual
CHANNA BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7027 N DRAYCOTT PL, PEORIA, IL 61615-9295
(309) 294-1425
Mailing address
7027 N DRAYCOTT PL, PEORIA, IL 61615-9295
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
112332
TX
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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