Individual
KAITLIN MARIE COLCLASURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 SAINT JOSEPH DR, BLOOMINGTON, IL 61701-3638
(309) 686-1177
Mailing address
1011 KINGSBURY RD, WASHINGTON, IL 61571-1208
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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