Individual
HALEY WOMBACHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 SAINT JOSEPH DR, BLOOMINGTON, IL 61701-3638
(309) 663-8275
Mailing address
507 E ARMSTRONG AVE, PEORIA, IL 61603-3201
(309) 686-1177
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-200997
IL
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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