Individual
DR. HERSHEL W STATHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
311 E MAIN ST, SUITE 414, GALESBURG, IL 61401-4855
(309) 343-8315
(309) 343-5164
Mailing address
311 E MAIN ST, SUITE 414, GALESBURG, IL 61401-4855
(309) 343-8315
(309) 343-5164
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
03/23/2006
Last updated
07/08/2007
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