Individual
CARLY MUSSELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
412 CRESTWOOD DR, SAINT JOSEPH, IL 61873-9429
(217) 504-7353
Mailing address
412 CRESTWOOD DR, SAINT JOSEPH, IL 61873-9429
(217) 504-7353
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.110380
IL
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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