Individual
DARYLNN JEAN PEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LPHA
Contact information
Practice address
137 E COLLEGE ST, KEWANEE, IL 61443-3703
(309) 854-0122
Mailing address
24883 CO HWY 14 1370 N, ANNAWAN, IL 61234
(309) 935-6090
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
370984175
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370984175
BWAY INC FEIN
IL
Enumeration date
04/17/2007
Last updated
04/14/2009
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