Individual
MS. TARA K EINSWEILER-MICKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7289 HICKORY CT, EAST DUBUQUE, IL 61025-9595
(815) 747-2646
Mailing address
7289 HICKORY CT, EAST DUBUQUE, IL 61025-9595
(815) 747-2646
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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