Individual
DANNETTE KINSELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1405 ARLEY HILL DR, O FALLON, IL 62269-7356
(618) 401-6842
Mailing address
1405 ARLEY HILL DR, O FALLON, IL 62269-7356
(618) 401-6842
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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