Provider Demographics
NPI:1467574558
Name:RAZER, BARBARA B (DEVELOPMENTAL THERAP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:B
Last Name:RAZER
Suffix:
Gender:F
Credentials:DEVELOPMENTAL THERAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 CYPRESS LN
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:IL
Mailing Address - Zip Code:62286-1054
Mailing Address - Country:US
Mailing Address - Phone:618-317-1130
Mailing Address - Fax:618-443-1019
Practice Address - Street 1:633 CYPRESS LN
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:IL
Practice Address - Zip Code:62286-1054
Practice Address - Country:US
Practice Address - Phone:618-317-1130
Practice Address - Fax:618-443-1019
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILBR98660399P174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist