Individual
TARA HALICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 N LOCUST ST, FRANKFORT, IL 60423-1263
(708) 209-6911
Mailing address
212 N LOCUST ST, FRANKFORT, IL 60423-1263
(708) 209-6911
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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