Individual
DONNA ROSE VONKANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1406 MAPLE AVE, MACOMB, IL 61455-3209
(309) 837-7791
(309) 837-1197
Mailing address
1406 MAPLE AVE, MACOMB, IL 61455-3209
(309) 837-7791
(309) 837-1197
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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