Doctor Name: | MRS. TRACEY A BOHL |
NPI Number: | 1932252764 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 146.007674 |
Business Practice Address: | 25231 Wagon Wheel Ln Frankfort, IL - 604237420 |
Business Phone Number: | 7086706720 |
Business Fax Number: | 8664386204 |
Mailing Address: | 25231 Wagon Wheel Ln, FRANKFORT |
State: | IL |
Postal Code: | 604237420 |
Phone Number: | 7086706720 |
Fax Number: | 8664386204 |
NPI Enumeration Date: | 01/18/2007 |
NPI Last Update Date: | 06/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.007674 |
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 |