Individual
MS. CARLY J WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
98 S GALENA AVE, 2ND FLOOR, DIXON, IL 61021-3034
(815) 285-1812
(815) 285-1833
Mailing address
702 COUNTRY CLUB DR, DIXON, IL 61021-9562
(815) 288-6256
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/25/2009
Last updated
09/25/2009
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