Individual
PAULA D. LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 E LOCUST ST, BLOOMINGTON, IL 61701-3006
(309) 268-3529
(309) 268-2323
Mailing address
PO BOX 2451, BLOOMINGTON, IL 61702-2451
(309) 268-2172
(309) 268-3649
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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