Individual
BRIANNA TABACJAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BHP
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-3395
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-3395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YA0400X
IL
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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