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1457984460
CARISSA WELTON NIEMERG
EFFINGHAM, IL
NPI
1457984460
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Former Name
CARISSA WELTON GOOSTREE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2020-02-18
Last Update Date
2020-02-18
Business Address
Mrs. CARISSA WELTON NIEMERG
14535 N AMBER LN
EFFINGHAM, IL 62401-4340
Phone number: 618-322-6918
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Mailing Address
Mrs. CARISSA WELTON NIEMERG
14535 N AMBER LN
EFFINGHAM, IL 62401-4340
Phone number: 618-322-6918
Copy
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