Individual
JEANTIELLE M GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
201 W CLAY ST, COLLINSVILLE, IL 62234-3219
(618) 346-6350
Mailing address
581 MANOR LN, MILLSTADT, IL 62260-2833
(618) 719-9804
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146012931
IL
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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