Individual
JAMIE WITHROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 HAVEN CT, FREEPORT, IL 61032-3507
(815) 233-6130
Mailing address
4 HAVEN CT, FREEPORT, IL 61032-3507
(815) 233-6130
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
05/25/2011
Last updated
05/25/2011
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