Individual
KATHRYN ELAINE STOCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
166 S PARK BLVD, GLEN ELLYN, IL 60137-6351
(541) 621-2638
Mailing address
166 S PARK BLVD, GLEN ELLYN, IL 60137-6351
(541) 621-2638
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
06/12/2017
Last updated
07/21/2022
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