Individual
STACEY LYNN CONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
910 MANLEY RD, ST. CHARLES, IL 60174
(630) 709-9271
Mailing address
910 MANLEY RD, ST. CHARLES, IL 60174
(630) 709-9271
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
10/28/2012
Last updated
12/10/2018
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