| The Autism Program At Southern Illinois University Carbondale | |
|
625 Wham Dr -mailcode 6607 Southern Illinois University Carbondale Carbondale IL 62901-4313 | |
| (618) 536-2122 | |
| (618) 453-7178 |
| Full Name | The Autism Program At Southern Illinois University Carbondale |
|---|---|
| Speciality | Clinic/center |
| Location | 625 Wham Dr -mailcode 6607, Carbondale, Illinois |
| Authorized Official Name and Position | Valerie Boyer (CENTER DIRECTOR) |
| Authorized Official Contact | 6184537130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Autism Program At Southern Illinois University Carbondale 625 Wham Dr Southern Illinois University Carbondale Carbondale IL 62901-4313 Ph: (618) 536-2122 | The Autism Program At Southern Illinois University Carbondale 625 Wham Dr -mailcode 6607 Southern Illinois University Carbondale Carbondale IL 62901-4313 Ph: (618) 536-2122 |
| NPI Number | 1477797801 |
|---|---|
| Provider Enumeration Date | 04/29/2009 |
| Last Update Date | 11/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477797801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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