Individual
MRS. TERESA GAIL ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2527 LAKE DR S, QUINCY, IL 62305-6482
(217) 228-2929
Mailing address
2527 LAKE DR S, QUINCY, IL 62305-6482
(217) 228-2929
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/18/2008
Last updated
11/24/2008
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