Doctor Name: | MRS. SHELLEY A MANNING |
NPI Number: | 1659412195 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 146-006630 |
Business Practice Address: | 414 W Hunter Ln Minooka, IL - 604474519 |
Business Phone Number: | 8154742146 |
Business Fax Number: | 8152905133 |
Mailing Address: | Po Box 17, MINOOKA |
State: | IL |
Postal Code: | 604470017 |
Phone Number: | 8154742146 |
Fax Number: | 8152905133 |
NPI Enumeration Date: | 02/09/2007 |
NPI Last Update Date: | 08/12/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146-006630 |
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 |