Individual
MARY SUE KRUCHTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
329 WESTPORT DR, PINGREE GROVE, IL 60140-9162
(847) 460-8934
Mailing address
329 WESTPORT DR, PINGREE GROVE, IL 60140-9162
(847) 460-7934
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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