Individual
MRS. SUSAN J. JUAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT-V, DT-O&M
Contact information
Practice address
374 PADDOCK DR W, SAVOY, IL 61874-9621
(217) 351-4843
Mailing address
374 PADDOCK DR W, SAVOY, IL 61874-9621
(217) 351-4843
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
SJ02220806P
IL
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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