NPI 1003525940

Elizabeth Divine

Practitioner Behavior Technician O Fallon, IL

Practice location

Address: 634 N Main St, O Fallon, IL 62269-3751
Phone: (618) 726-5870

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

Other Behavior Technician providers in Illinois →

Registry record

NPI: 1003525940
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Nov 2022
Record last updated: 18 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.