IndividualActive
Elizabeth Divine
NPI 1003525940 · Behavior Technician · O Fallon, IL
Elizabeth Divine is a Behavior Technician provider in O Fallon, IL (NPI 1003525940).
Provider details
- NPI number
- 1003525940
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
Practice location
634 N Main St
O Fallon, IL 62269-3751
Phone: (618) 726-5870
Street-level locationGet directions
Mailing address
634 N Main St
O Fallon, IL 62269-3751
Registry dates
- Enumerated
- 2022-11-18
- Last updated
- 2022-11-18
- Certified
- 2022-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.