Individual
NICOLE STANFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
15679 NIGHT GALLERY LN, JERSEYVILLE, IL 62052-0016
(618) 340-3031
(877) 542-5281
Mailing address
15679 NIGHT GALLERY LN, JERSEYVILLE, IL 62052-0016
(618) 340-3031
(877) 542-5281
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150119233
IL
Other
Enumeration date
06/13/2026
Last updated
06/13/2026
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