Most Relevant Information
Provider Data
| NPI Number: | 1003174178 |
| Provider Name: | RENAE PETER M.S, SLP-CCC |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 146010152 |
Most Important Dates
| Enumeration Date: | 04/26/2012 |
| Last Updated: | 04/26/2012 |
Provider Practice Location
12363 LAGUNA DR
MARION
IL
629599040
Practice Location Phone/Fax
| Phone: | 6182632385 |
| Fax: |
Provider Mailing Location
12363 LAGUNA DR
MARION
IL
629599040
Provider Mailing Phone/Fax
| Phone: | 6182632385 |
| Fax: |