Individual
HEATHER E TAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 N HOLLY RD, OLNEY, IL 62450-4463
(618) 395-8540
Mailing address
1001 N HOLLY RD, OLNEY, IL 62450-4463
(618) 395-8540
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.005278
IL
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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