| Organization Name: | SOUTHERN REHAB SPECIALISTS, LLC |
| NPI Number: | 1699020552 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARAH RENEE SURPRENANT (OWNER, OCCUPATIONAL THERAPIST) |
| Mailing Address: | 3216 Mustang Ct Herrin |
| State: | IL US |
| Postal Code: | 629483783 |
| Phone Number: | 6185595610 |
| Fax Number: | |
| NPI Enumeration Date: | 07/17/2012 |
| NPI Last Update Date: | 07/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 146.009800 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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 |