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General NPI Number Information
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NPI Number | 1669041463
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Entity Type | Organization
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Legal Business Name | HERRON SPEECH THERAPY, PLLC
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 510 MARKET LOOP STE 102
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City | WEST DUNDEE
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State | IL
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Zip | 60118-2139
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Country | US
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Telephone | 224-212-9140
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Fax |
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Provider Business Mailing Address
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Address Line | 917 WILLOW LN
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City | SLEEPY HOLLOW
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State | IL
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Zip | 60118-1914
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Country | US
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Telephone | 847-722-5512
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Fax |
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Authorized Official
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Title or Position | OWNER, SPEECH-LANGUAGE PATHOLOGIST
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Name | PATRICIA L HERRON
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Credential | MA, CCC-SLP/L
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Telephone | 847-722-5512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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