Most Relevant Information
Provider Data
| NPI Number: | 1003066564 |
| Provider Name: | NICOLE GAYLE KNEER MS CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 146.006333 |
Most Important Dates
| Enumeration Date: | 09/22/2008 |
| Last Updated: | 09/22/2008 |
Provider Practice Location
202 N. PINE ST.
VILLA GROVE
IL
619561426
Practice Location Phone/Fax
| Phone: | 2178322147 |
| Fax: |
Provider Mailing Location
202 N. PINE ST.
VILLA GROVE
IL
619561426
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |