Individual
MICHELLE RENEE CONDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, CADC
Contact information
Practice address
325 IL ROUTE 2, DIXON, IL 61021-9118
(815) 973-1077
Mailing address
325 IL ROUTE 2, DIXON, IL 61021-9118
(815) 973-1077
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37961
IL
104100000X
Social Worker
Primary
150107507
IL
Other
Enumeration date
04/22/2024
Last updated
02/21/2025
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