Child and Adolescent Neuropsychology Services of Southern Illinois, Pl
NPI #1255961348 in Carbondale, Illinois
Provider Information
- NPI Number
- 1255961348
- Entity Type
- Organization
- Organization Name
- Child and Adolescent Neuropsychology Services of Southern Illinois, Pl
- Primary Specialty
- Clinic/Center - Adolescent and Children Mental Health
- Enumeration Date
- Jan 17, 2020
- Last Updated
- Jan 17, 2020
Practice Location
- Address
- 285 LAKE INDIAN HILLS DR
- City
- Carbondale
- State
- Illinois
- ZIP Code
- 62902-6184
- Phone
- (618) 490-1263
Authorized Official
- Name
- MICHELLE YVONNE KIBBY-FAGLIER, PHD
- Title
- CLINICAL NEUROPSYCHOLOGIST
- Phone
- (618) 201-8828
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Developmental Disabilities — Developmental Disabilities |
| Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health |
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