Individual
MISS MOLLY SUE RAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT/H
Contact information
Practice address
431 W KNOLL CREST DR, PEORIA, IL 61614-7219
(309) 453-8551
Mailing address
431 W KNOLL CREST DR, PEORIA, IL 61614-7219
(309) 453-8551
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
R500-5578-2913
IL
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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