Doctor Name: | MANDY DEOPERE |
NPI Number: | 1689879819 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC SLP |
License Number: | |
Business Practice Address: | 14425 Kildare Ave Midlothian, IL - 604452649 |
Business Phone Number: | 7083095459 |
Business Fax Number: | 7085975422 |
Mailing Address: | 10312 S Keating Ave, B-6 OAK LAWN |
State: | IL |
Postal Code: | 604534756 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
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 |