Individual
ALLEGRA LEIGH WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1510 W OTTAWA RD, PAXTON, IL 60957-4090
(217) 379-4302
(217) 817-0379
Mailing address
PO BOX 162, PAXTON, IL 60957-0162
(217) 379-4302
(217) 817-0379
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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