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General NPI Number Information
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NPI Number | 1043403959
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Entity Type | Individual
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Provider Name | AMY JOAN UEBELHOER M.S.CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 402 CENTER ST
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City | DURAND
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State | IL
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Zip | 61024-9590
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Country | US
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Telephone | 815-248-2151
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Fax | 815-248-2771
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Provider Business Mailing Address
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Address Line | 402 CENTER ST
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City | DURAND
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State | IL
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Zip | 61024-9590
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Country | US
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Telephone | 815-248-2151
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Fax | 815-248-2771
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146005378
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License Number State | IL
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