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Individual

SUSAN GUNNING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
724 LINDEN ST, ALTON, IL 62002-3740
(618) 465-7724
(618) 465-7724
Mailing address
724 LINDEN ST, ALTON, IL 62002-3740
(618) 465-7724
(618) 465-7724

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
IL

Other

Enumeration date
12/27/2007
Last updated
12/27/2007
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