Individual
MRS. JODIANN HULSTEDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MFT
Contact information
Practice address
3493 FAWNRIDGE DR, ROCKFORD, IL 61114-5496
(815) 997-1043
Mailing address
3493 FAWNRIDGE DR, ROCKFORD, IL 61114-5496
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166.001043
IL
Other
Enumeration date
11/12/2015
Last updated
01/12/2016
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