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Organization
RESTORE WELLNESS COUNSELING LLC
Active
Organization
RESTORE WELLNESS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICHELE DEANNE HAWBAKER LCSW (LICENSED CLINICAL SOCIAL WORKER)
(217) 972-0744
Entity
Organization
Contact information
Practice address
106 NORTH MAIN STREET, DECATUR, IL 62523
(779) 220-0441
Mailing address
106 N MAIN ST, DECATUR, IL 62523-1207
(779) 220-0441
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
10/30/2020
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