| NPI | 1255705893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LYN MALLARD Developmental Therapist 815-671-7092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |