Doctor Name: | MS. SARA IRENE MITCHINSON |
NPI Number: | 1720334758 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.,CCC-SLP/L |
License Number: | 146.004614 |
Business Practice Address: | 500 Coventry Ln Ste 170 Crystal Lake, IL - 600147592 |
Business Phone Number: | 8153562700 |
Business Fax Number: | 8153562709 |
Mailing Address: | 516 Saratoga Dr, ELBURN |
State: | IL |
Postal Code: | 601198338 |
Phone Number: | 6303653548 |
Fax Number: | |
NPI Enumeration Date: | 07/27/2012 |
NPI Last Update Date: | 07/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.004614 |
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 |