Individual
MRS. BETTY LEE CROISSANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 N 37TH ST, BELLEVILLE, IL 62226-6008
(618) 233-1560
Mailing address
PO BOX 224, SMITHTON, IL 62285-0224
(618) 233-1560
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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