| NPI | 1972553709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HILL Controller 618-234-6876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146001171) |
| 225100000X Physical Therapist (Licence: IL 070005518) | |
| 225100000X Physical Therapist (Licence: IL 070003265) | |
| 235Z00000X Speech-Language Pathologist, (Licence: IL 146008735) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2008-03-07 |