Individual
SAMANTHA BEVERLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
4501 HILL RD, HIGHLAND, IL 62249-3519
(618) 830-6562
Mailing address
2609 2ND AVE, ROCKFORD, IL 61108-1704
(815) 708-5829
(618) 503-0263
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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