Individual
MS. JANE KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
35 ALBANY RD, SUITE E, CARBONDALE, IL 62903-7605
(618) 241-2128
(618) 241-3848
Mailing address
PO BOX 587, CENTRALIA, IL 62801-9110
(618) 241-2128
(618) 241-3848
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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