Individual
DIANA LYNN STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
229 SHADOWBROOKE, TROY, IL 62294-3631
(618) 505-0167
Mailing address
229 SHADOWBROOKE, TROY, IL 62294-3631
(618) 505-0167
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/10/2009
Last updated
06/10/2009
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