Henrietta Boudros, MA, CCC-SLP
Speech-Language Pathologist, in Chicago, IL. Individual provider (NPI-1).
NPI number1609900596
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1609900596
- Entity type
- Individual (NPI-1)
- Name
- Henrietta Boudros
- Credential
- MA, CCC-SLP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 15, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 146007085 | IL | Yes |
Practice location
345 E Superior StChicago, IL 60611-2654
Phone 312-238-5939
Mailing address
1120 N La Salle Dr Apt 19mChicago, IL 60610-7613
Phone 312-217-5602
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