Abbie John
Individual provider Active NPI School Psychologist · Liberty, IL
NPI 1750896452 · NPPES record last updated Dec 5, 2017
Key facts
- NPI
- 1750896452
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- Practice address
- 1066 E 2250TH St
Liberty, IL 62347-2205 - Phone
- (217) 617-5948
- NPI assigned
- Dec 5, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Yes |
Addresses
Primary practice location
1066 E 2250TH St
Liberty, IL 62347-2205
Mailing address
1066 E 2250TH St
Liberty, IL 62347-2205
Other providers in Liberty, IL
All providers in Liberty, IL · School Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.