Individual
MISS MICHELLE LEE MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT-BC, NMT
Contact information
Practice address
816 S. FIRST ST., PRINCETON, IL 61356
(815) 875-5848
(815) 875-5848
Mailing address
115 WEST SEMINOLE ST., DWIGHT, IL 60420-1151
(815) 584-2246
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
07735
IL
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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