Individual
MS. SUSAN EILEEN ENGELHARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1308 WELLS STREET RD, DU QUOIN, IL 62832-4171
(618) 542-5421
(618) 542-5556
Mailing address
1308 WELLS STREET RD, DU QUOIN, IL 62832-4171
(618) 542-5421
(618) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178004845
IL
Other
Enumeration date
08/07/2009
Last updated
08/07/2009
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