Individual
MARY KATHRYN TERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
12 N 64TH ST, BELLEVILLE, IL 62223-3809
(618) 877-4420
Mailing address
448 WYLIE DR STE 400, NORMAL, IL 61761-5405
(618) 512-1502
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.016917
IL
172V00000X
Community Health Worker
—
—
Other
Enumeration date
03/05/2013
Last updated
07/28/2021
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