Individual
HAYLEE ANN COHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
605 S VAN BUREN ST, NEWTON, IL 62448-1651
(618) 783-7529
Mailing address
605 S VAN BUREN ST, NEWTON, IL 62448-1651
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1051845
IL
Other
Enumeration date
03/21/2024
Last updated
02/19/2025
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