Individual
EMMA WIELICZKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
132 S WATER ST STE 604, DECATUR, IL 62523-1061
(217) 620-0821
Mailing address
132 S WATER ST STE 604, DECATUR, IL 62523-1061
(217) 620-0821
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/06/2019
Last updated
09/06/2019
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