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Individual

MS. JACQUELINE CHRISTINE THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2430
Mailing address
706 W HEALEY ST, CHAMPAIGN, IL 61820-5027
(217) 390-1042

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
07/29/2013
Last updated
07/29/2013
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