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Individual

NICOLE HENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5801 MOUNT PLEASANT LN, BELLEVILLE, IL 62223-3944
(618) 489-5102
Mailing address
2025 WINTERS DR, LOVES PARK, IL 61111-3257
(815) 616-2559

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150114186
IL

Other

Enumeration date
01/24/2025
Last updated
01/24/2025
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