Organization
MILLER TWP C.C. SCHOOL #210
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH BROM (BOOKKEEPER)
(815) 357-8151
Entity
Organization
Contact information
Practice address
3197 E 28TH RD, MARSEILLES, IL 61341-9567
(815) 357-8151
Mailing address
3197 E 28TH RD, MARSEILLES, IL 61341-9567
(815) 357-8151
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
02262008986443
IL
235Z00000X
Speech-Language Pathologist
1600814
IL
Other
Enumeration date
02/27/2008
Last updated
04/20/2008
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