Individual
JENNIFER LYNN BAGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
660 INDIGO LN, WOODSTOCK, IL 60098-3608
(815) 404-3505
Mailing address
660 INDIGO LN, WOODSTOCK, IL 60098-3608
(815) 404-3505
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
B22043283696
IL
Other
Enumeration date
03/26/2008
Last updated
03/26/2008
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