Skill Sprout Diagnostic | |
102 Walnut Street Washington IL 61571 | |
(800) 773-1682 | |
(800) 773-1682 |
Full Name | Skill Sprout Diagnostic |
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Speciality | Behavior Analyst |
Location | 102 Walnut Street, Washington, Illinois |
Authorized Official Name and Position | Amy Shymansky (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 8007731682 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Skill Sprout Diagnostic 102 Walnut Street Washington IL 61571 Ph: (800) 773-1682 | Skill Sprout Diagnostic 102 Walnut Street Washington IL 61571 Ph: (800) 773-1682 |
NPI Number | 1871885756 |
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Provider Enumeration Date | 05/10/2011 |
Last Update Date | 05/10/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871885756 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | 1-09-6597 (Illinois) | Primary |
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