Leaning Fence Therapy Center Llc | |
8453 S Schiller St Dorsey IL 62021-1807 | |
(618) 417-7126 | |
Not Available |
Full Name | Leaning Fence Therapy Center Llc |
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Speciality | Social Worker - Clinical |
Location | 8453 S Schiller St, Dorsey, Illinois |
Authorized Official Name and Position | Jennifer Koranyi (OWNER) |
Authorized Official Contact | 6184177126 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Leaning Fence Therapy Center Llc 8453 S Schiller St Dorsey IL 62021-1807 Ph: (618) 417-7126 | Leaning Fence Therapy Center Llc 8453 S Schiller St Dorsey IL 62021-1807 Ph: (618) 417-7126 |
NPI Number | 1790513380 |
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Provider Enumeration Date | 07/24/2024 |
Last Update Date | 07/24/2024 |
Certification Date | 07/24/2024 |
Identifier | Type | State | Issuer |
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1790513380 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |