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1790253268
ELSIE FAROUGH
CARBONDALE, IL
NPI
1790253268
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.018982)
Enumeration Date
2018-11-02
Last Update Date
2018-11-02
Business Address
ELSIE FAROUGH
2311 S ILLINOIS AVE
CARBONDALE, IL 62903-5912
Phone number: 618-457-6703
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Mailing Address
ELSIE FAROUGH
902 W MAIN ST
WEST FRANKFORT, IL 62896-2210
Phone number: 618-937-6483
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