Provider Demographics
NPI:1538488259
Name:HERRON, PATRICIA (CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:HERRON
Suffix:
Gender:F
Credentials:CCC-SLP/L
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:SCHNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP/L
Mailing Address - Street 1:917 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:IL
Mailing Address - Zip Code:60118-1914
Mailing Address - Country:US
Mailing Address - Phone:847-722-5512
Mailing Address - Fax:
Practice Address - Street 1:917 WILLOW LN
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:IL
Practice Address - Zip Code:60118-1914
Practice Address - Country:US
Practice Address - Phone:847-722-5512
Practice Address - Fax:847-426-1015
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010111235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist