Individual
ELISHA MARIE LONERGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 BUCKHORN CIR, JACKSONVILLE, IL 62650-6733
(217) 473-9633
Mailing address
8 BUCKHORN CIR, JACKSONVILLE, IL 62650-6733
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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