Organization
LITTLE GREEN PIPSQUEAK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME B MOSSMAN (PRESIDENT)
(630) 204-3366
Entity
Organization
Contact information
Practice address
4620 HIGHLAND AVE, DOWNERS GROVE, IL 60515-2814
(630) 204-3366
Mailing address
4620 HIGHLAND AVE, DOWNERS GROVE, IL 60515-2814
(630) 204-3366
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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