Individual
TIA BURNS LEABU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHP
Contact information
Practice address
1016 S MADISON ST, DU QUOIN, IL 62832-2442
(618) 542-4357
(618) 542-3442
Mailing address
1016 S MADISON ST, DU QUOIN, IL 62832-2442
(618) 542-4357
(618) 542-3442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/18/2019
Last updated
11/27/2023
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