Individual
MRS. DIANE RENE' RAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
1335 W RAVINA AVE, DECATUR, IL 62526-3136
(217) 972-1553
(217) 872-1491
Mailing address
1335 W RAVINA AVE, DECATUR, IL 62526-3136
(217) 972-1553
(217) 872-1491
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055
—
IL
Enumeration date
05/01/2007
Last updated
07/09/2007
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