Individual
MRS. TERESA LYNN POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.T.
Contact information
Practice address
210 SHANNON LAKE CIR, ANNA, IL 62906-0015
(618) 444-3915
Mailing address
210 SHANNON LAKE CIR, ANNA, IL 62906-0015
(618) 444-3915
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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