Individual
REBECCA LYNN WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9501 SHATUC RD, CENTRALIA, IL 62801-5833
(618) 226-3534
Mailing address
9501 SHATUC RD, CENTRALIA, IL 62801-5833
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/06/2010
Last updated
03/06/2010
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