Individual
MRS. SEGOLENE WAECHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1108 N GLENWOOD AVE, PEORIA, IL 61606-1009
(309) 863-9644
Mailing address
1108 N GLENWOOD AVE, PEORIA, IL 61606-1009
(309) 863-9644
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-41328
IL
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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