Individual
MRS. CARLA BECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 S 3RD ST, ALTAMONT, IL 62411-1102
(618) 483-3062
Mailing address
12 S 3RD ST, ALTAMONT, IL 62411-1102
(618) 483-3062
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
CB87150998P
IL
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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