Individual
DR. NICOLE PACHECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 S 4TH AVE, SUITE 140, MORTON, IL 61550-2889
(309) 868-2495
Mailing address
PO BOX 995, MORTON, IL 61550-0995
(309) 868-2495
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007442
IL
Other
Enumeration date
10/13/2009
Last updated
07/28/2010
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