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1184013955
KRISTA TECKENBROCK
HERRIN, IL
NPI
1184013955
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2015-01-16
Last Update Date
2015-01-16
Business Address
-- KRISTA TECKENBROCK
37 DOUGLAS DR
HERRIN, IL 62948-4232
Phone number: 618-988-6859
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Mailing Address
-- KRISTA TECKENBROCK
37 DOUGLAS DR
HERRIN, IL 62948-4232
Phone number: 618-988-6859
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