Organization
EDEGWOOD CLINCIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ABBY KOCH LCSW (CLINCIAL THERAPIST)
(847) 962-6731
Entity
Organization
Contact information
Practice address
1288 RICKERT DR, NAPERVILLE, IL 60540-0951
(630) 428-7890
Mailing address
1288 RICKERT DR, NAPERVILLE, IL 60540-0951
(630) 428-7890
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149.012640
IL
Other
Enumeration date
02/15/2010
Last updated
02/15/2010
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