Individual
ANTOINETTE HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 W LAMM RD, FREEPORT, IL 61032-9630
(815) 233-6162
Mailing address
701 W LAMM RD, FREEPORT, IL 61032-9630
(815) 233-6162
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37-1372148
—
IL
Enumeration date
11/04/2016
Last updated
11/04/2016
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