Organization
GOOD SHEPHERD CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY J GUYMON DT (DEVELOPMENTAL THERAPIST)
(815) 806-0307
Entity
Organization
Contact information
Practice address
529 COTTONWOOD RD, FRANKFORT, IL 60423-1009
(815) 806-0307
Mailing address
529 COTTONWOOD RD, FRANKFORT, IL 60423-1009
(815) 806-0307
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
252Y00000X
IL
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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