Belleville Area Special Services Cooperative | |
2411 Pathways Xing Belleville IL 62221-5885 | |
(618) 355-4700 | |
Not Available |
Full Name | Belleville Area Special Services Cooperative |
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Speciality | Psychologist - School |
Location | 2411 Pathways Xing, Belleville, Illinois |
Authorized Official Name and Position | Jeff Daugherty (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6183554719 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Belleville Area Special Services Cooperative 2411 Pathways Xing Belleville IL 62221-5885 Ph: (618) 355-4700 | Belleville Area Special Services Cooperative 2411 Pathways Xing Belleville IL 62221-5885 Ph: (618) 355-4700 |
NPI Number | 1679090997 |
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Provider Enumeration Date | 08/28/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679090997 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TS0200X | Psychologist - School | 394137 (Illinois) | Primary |
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