Provider Demographics
NPI:1073037107
Name:CHANDRAMOULI, HARINI (SLPA)
Entity Type:Individual
Prefix:
First Name:HARINI
Middle Name:
Last Name:CHANDRAMOULI
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7S341 AUGUSTA LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-9414
Mailing Address - Country:US
Mailing Address - Phone:708-571-9806
Mailing Address - Fax:
Practice Address - Street 1:7S341 AUGUSTA LN
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-9414
Practice Address - Country:US
Practice Address - Phone:708-571-9806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-20-119647106S00000X
IL2170003702355S0801X
IL1-22-60574103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant