Individual
CHARLOTTE CEARLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
907 KENTUCKY ST, QUINCY, IL 62301-4153
(618) 339-3700
Mailing address
907 KENTUCKY ST, QUINCY, IL 62301-4153
(618) 339-3700
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/02/2017
Last updated
01/02/2017
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