Individual
MS. MARY TERESE ANNE SQUEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT, CYT
Contact information
Practice address
8626 DUNBAR ST, WILLOW SPRINGS, IL 60480-1165
(708) 202-4913
Mailing address
8626 DUNBAR ST., WILLOW SPRINGS, IL 60480
(708) 202-4913
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
225800000X
IL
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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