Doctor Name: | DANIELLE JANDRIS |
NPI Number: | 1245627876 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 242.003163 |
Business Practice Address: | 900 N Rutledge St Springfield, IL - 627023721 |
Business Phone Number: | 2177890930 |
Business Fax Number: | |
Mailing Address: | 1619 Cutter Ct, NORMAL |
State: | IL |
Postal Code: | 617614818 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/21/2015 |
NPI Last Update Date: | 04/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 242.003163 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |