Individual
JOAN ALICE WEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 SUNRISE TRL, CARBONDALE, IL 62902-7523
(618) 553-1476
Mailing address
110 SUNRISE TRL, CARBONDALE, IL 62902-7523
(618) 553-1476
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/21/2008
Last updated
06/21/2008
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