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Mary Fafara, SLP

Speech-Language Pathologist, in Decatur, IL. Individual provider (NPI-1).

NPI number1982114112
StatusActive
Last updated in NPPESOct 2, 2017

Details

NPI
1982114112
Entity type
Individual (NPI-1)
Name
Mrs. Mary Fafara
Credential
SLP
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 2, 2017
Last updated
Oct 2, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,12132766ILYes

Practice location

520 W Wood St
Decatur, IL 62522-3112

Phone 217-362-3385

Mailing address

520 W Wood St
Decatur, IL 62522-3112

Phone 217-362-3385

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