Alison Goley

Individual provider Active NPI Speech-Language Pathologist · Mapleton, IL

NPI 1316197916 · NPPES record last updated Aug 30, 2018

Key facts

NPI
1316197916
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146.010127 (IL)
Practice address
9438 W Lake Camelot Dr
Mapleton, IL 61547
Phone
(630) 740-1182
Fax
(309) 697-5574
NPI assigned
Sep 19, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
146.010127ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.010127 IL Yes

Addresses

Primary practice location

9438 W Lake Camelot Dr
Mapleton, IL 61547

Mailing address

9438 W Lake Camelot Dr
Mapleton, IL 61547-9328
Phone (630) 740-1182

Other providers in Mapleton, IL

All providers in Mapleton, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.