Individual
ELAINE B COMBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DEVELOPMENTAL THERAP
Contact information
Practice address
708 N 16TH ST, HERRIN, IL 62948-1219
(618) 942-7481
(618) 942-7481
Mailing address
708 N 16TH ST, HERRIN, IL 62948-1219
(618) 942-7481
(618) 942-7481
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
EC#56871199 P
IL
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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