Individual
INDEA POWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 E LINCOLN ST, NORMAL, IL 61761-6406
(309) 240-6473
Mailing address
705 E LINCOLN ST, NORMAL, IL 61761-6406
(309) 240-6473
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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