Individual
MRS. JENNIE MARIE GURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 MASSASOIT ST, MINOOKA, IL 60447-9149
(815) 274-5750
Mailing address
209 MASSASOIT ST, MINOOKA, IL 60447-9149
(815) 274-5750
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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