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General NPI Number Information
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NPI Number | 1154847366
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Entity Type | Individual
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Provider Name | MRS. JOYCE SUSAN DACHAUER
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Gender | Female
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 805 N. BARNETT ST.
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City | LEROY
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State | IL
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Zip | 61752
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Country | US
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Telephone | 309-962-4771
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Fax | 309-962-2893
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Provider Business Mailing Address
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Address Line | 2009 N. HAVERHILL CC PARK
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City | NORMAL
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State | IL
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Zip | 61761
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Country | US
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Telephone | 309-242-7762
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Fax |
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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 | 146.004887
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License Number State | IL
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