Individual
AMANDA LYNN JECKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1964 COLUMBUS ST, OTTAWA, IL 61350-1575
(815) 416-8103
Mailing address
1964 COLUMBUS ST, OTTAWA, IL 61350-1575
(815) 416-8103
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.108346
IL
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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