Individual
BARBARA H VINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
100 S SUMMIT ST, PEARL CITY, IL 61062-8816
(815) 443-2715
Mailing address
NORTHWEST SPECIAL EDUCATION COOP, 310 WEST STREET, ELIZABETH, IL 61028
(815) 599-1947
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1826603
IL
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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