Individual
KATELYN BELLE VAN VICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
7 DOCTORS PARK, GIBSON CITY, IL 60936-2000
(217) 784-5500
(217) 784-4106
Mailing address
7 DOCTORS PARK, GIBSON CITY, IL 60936-2000
(217) 784-5500
(217) 784-4106
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.105484
IL
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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