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Organization

RUBY WAVES OF WELLNESS

Active
Other names
Josie D Mitchell
Organization subpart
No

Provider details

NPI number
Authorized official
JOSIE DORTHEA MITCHELL LCSW (LCSW/OWNER)
(765) 761-3997
Entity
Organization

Contact information

Practice address
105 W PRAIRIE AVE, OGDEN, IL 61859-8808
(217) 274-2363
Mailing address
PO BOX 374, OGDEN, IL 61859-0374
(217) 274-2363

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
149019804
LCSW
IL
05
1740650530
IL
Enumeration date
09/12/2022
Last updated
04/15/2023
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