Provider Demographics
NPI:1619348778
Name:PRACTICAL NETWORK CONSULTING INC
Entity Type:Organization
Organization Name:PRACTICAL NETWORK CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-942-5096
Mailing Address - Street 1:858 STARLIGHT CT
Mailing Address - Street 2:
Mailing Address - City:HERRIN
Mailing Address - State:IL
Mailing Address - Zip Code:62948-2445
Mailing Address - Country:US
Mailing Address - Phone:618-942-5096
Mailing Address - Fax:
Practice Address - Street 1:858 STARLIGHT CT
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-2445
Practice Address - Country:US
Practice Address - Phone:618-942-5096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency