Individual
JENNIFER TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
421 W EXCHANGE ST, FREEPORT, IL 61032-4008
(815) 599-7300
Mailing address
PO BOX 813, FREEPORT, IL 61032-0813
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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