Individual
LINDSAY BANNERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, ED.S.
Contact information
Practice address
400 N PINE ST, MOMENCE, IL 60954-1158
(815) 472-3501
Mailing address
9461 RENAISSANCE DR, SAINT JOHN, IN 46373-8721
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2382070
IL
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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