Doctor Name: | CRETIA DAUBY |
NPI Number: | 1437421864 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN-BC, QMHP |
License Number: | 041.201982 |
Business Practice Address: | 1412 Us Highway 45 N Eldorado, IL - 629303766 |
Business Phone Number: | 6182733326 |
Business Fax Number: | |
Mailing Address: | 1412 Us Highway 45 N, ELDORADO |
State: | IL |
Postal Code: | 629303766 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/01/2012 |
NPI Last Update Date: | 02/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 041.201982 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |