Provider Demographics
NPI:1538857859
Name:ANDRIANO, CAMERON MICHELLE (MHS, SLP)
Entity type:Individual
Prefix:MS
First Name:CAMERON
Middle Name:MICHELLE
Last Name:ANDRIANO
Suffix:
Gender:F
Credentials:MHS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E COURT ST STE 708
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3845
Mailing Address - Country:US
Mailing Address - Phone:815-304-5548
Mailing Address - Fax:
Practice Address - Street 1:200 E COURT ST STE 708
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3845
Practice Address - Country:US
Practice Address - Phone:815-304-5548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.007150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist