Angela Rae Harsy, M.S. BCBA

Individual provider Active NPI Behavior Analyst · Du Quoin, IL

NPI 1770970964 · NPPES record last updated Apr 25, 2015

Key facts

NPI
1770970964
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-14-16352 (IL)
Practice address
847 Wells Street Rd
Du Quoin, IL 62832-4161
Phone
(618) 559-2169
NPI assigned
Apr 25, 2015
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
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-14-16352 IL Yes

Addresses

Primary practice location

847 Wells Street Rd
Du Quoin, IL 62832-4161

Mailing address

847 Wells Street Rd
Du Quoin, IL 62832-4161
Phone (618) 559-2169

Other providers in Du Quoin, IL

All providers in Du Quoin, IL · Behavior Analyst in Illinois

Sources for this page

Verify at the official NPI Registry.