Individual
MOLLY SHAWNAKAYE DURBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 LEAVERTON ST, APT. #6, POCAHONTAS, IL 62275-3010
(618) 570-1102
Mailing address
510 LEAVERTON ST, APT. #6, POCAHONTAS, IL 62275-3010
(618) 570-1102
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113860332
—
IL
Enumeration date
03/28/2017
Last updated
03/28/2017
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