Individual
KAITLIN COSTELLO JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
207 E HAMILTON RD, BLOOMINGTON, IL 61704-7527
(217) 274-8953
Mailing address
585 BASSWOOD LN, NORMAL, IL 61761-5749
(217) 274-8953
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.101368
IL
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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