Individual
JESSICA JOHANNA PICKENS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1200 N 4TH ST, EFFINGHAM, IL 62401-3032
(217) 347-7179
Mailing address
11416 N 200TH ST, WHEELER, IL 62479-2447
(217) 925-5868
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
Other
Enumeration date
11/23/2005
Last updated
07/08/2007
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