Individual
MRS. FAWN ANN FOLKERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EC SPE ED TEACHER
Contact information
Practice address
4504 BLACKWOLF RD, SPRINGFIELD, IL 62711-7871
(217) 726-8286
Mailing address
4504 BLACKWOLF RD, SPRINGFIELD, IL 62711-7871
(217) 726-8286
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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