Individual
CARRIE COON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1741 HOLMES AVE, SPRINGFIELD, IL 62704-4033
(217) 741-7425
Mailing address
1741 HOLMES AVE, SPRINGFIELD, IL 62704-4033
(217) 741-7425
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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