Individual
MEL ROETHLISBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
760 FOXPOINTE DR, SYCAMORE, IL 60178-3290
(815) 748-8334
Mailing address
760 FOXPOINTE DR, SYCAMORE, IL 60178-3290
(815) 748-8334
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
150.112518
—
Other
Enumeration date
01/16/2023
Last updated
12/15/2023
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