Elisha Marie Lonergan

NPI #1417250812 in Jacksonville, Illinois

Provider Information

NPI Number: 1417250812
Entity Type: Individual
Name: Elisha Marie Lonergan
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Enumeration Date: Dec 7, 2010
Last Updated: Dec 7, 2010

Practice Location

Address: 8 BUCKHORN CIR
City: Jacksonville
State: Illinois
ZIP Code: 62650-6733
Phone: (217) 473-9633

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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