Individual
PAMELA VANHESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 GOUGAR RD, JOLIET, IL 60432-9787
(815) 485-8146
Mailing address
911 N RAYNOR AVE, JOLIET, IL 60435-4652
(773) 320-4312
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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