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Individual

MR. KRISTINA LINDA SOMMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
650 W WILLIAM ST, DECATUR, IL 62522-2326
(217) 422-5249
Mailing address
500 E LAKE SHORE DR, DECATUR, IL 62521-3336
(217) 475-2234

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1740081
IL

Other

Enumeration date
10/09/2007
Last updated
10/09/2007
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