Individual
LINDA MUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
403 MUNICIPAL DR, CARTERVILLE, IL 62918-2042
(618) 937-6483
Mailing address
1195 E WALNUT ST APT K7, CARBONDALE, IL 62901-5021
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-17-28837
—
103K00000X
Behavior Analyst
Primary
1-22-59470
—
Other
Enumeration date
09/11/2019
Last updated
03/24/2023
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