Individual
DESIRAE PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1126 HEALTHCARE DR, MOUNT CARROLL, IL 61053-1469
(815) 244-4200
Mailing address
1126 HEALTHCARE DR, MOUNT CARROLL, IL 61053-1469
(815) 244-4200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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