Individual
MRS. MALLORY SUSANN YEAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
902 W MAIN ST, WEST FRANKFORT, IL 62896-2210
(618) 937-6483
Mailing address
902 W MAIN ST, WEST FRANKFORT, IL 62896-2210
(618) 937-6483
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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