Individual
DESMA ELIZABETH MANIGAULT-MCELVEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
145 APPLE ORCHARD RD, CARBONDALE, IL 62903-7673
(843) 810-3331
Mailing address
145 APPLE ORCHARD RD, CARBONDALE, IL 62903-7673
(843) 810-3331
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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