Individual
MS. AMY B HUSTON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
560 S MAIN ST, ROSEVILLE, IL 61473-9619
(309) 371-5422
Mailing address
560 S MAIN ST, ROSEVILLE, IL 61473-9619
(309) 371-5422
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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