Tiffany Kragenbrink

NPI #1720578503 in Rockton, Illinois

Provider Information

NPI Number: 1720578503
Entity Type: Individual
Name: Tiffany Kragenbrink
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 16, 2018
Last Updated: May 16, 2018

Practice Location

Address: 58 W ROCKTON RD
City: Rockton
State: Illinois
ZIP Code: 61072-1699
Phone: (815) 624-8431

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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