Individual
LAURA BALTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
785 WALL ST STE 200, O FALLON, IL 62269-1959
(618) 567-3693
Mailing address
785 WALL ST STE 200, O FALLON, IL 62269-1959
(618) 567-3693
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2137088
IL
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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