Individual
MRS. NICOLE R CUMMINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 BUTTON CT, BRIGHTON, IL 62012-1348
(618) 372-4866
Mailing address
405 BUTTON CT, BRIGHTON, IL 62012-1348
(618) 372-4866
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
2219354
IL
Other
Enumeration date
08/12/2010
Last updated
10/25/2010
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