Individual
KAZU TAKEGUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3022 S PARK AVE, HERRIN, IL 62948-3721
(618) 967-1567
Mailing address
3022 S PARK AVE, HERRIN, IL 62948-3721
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/13/2011
Last updated
02/15/2023
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