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1043920036
NATHANIEL BRANCH
DEKALB, IL
NPI
1043920036
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2022-11-30
Last Update Date
2022-11-30
Business Address
NATHANIEL BRANCH
12 HEALTH SERVICES DR
DEKALB, IL 60115-9637
Phone number: 815-756-4875
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Mailing Address
NATHANIEL BRANCH
PO BOX 1109
DEKALB, IL 60115-7109
Phone number: 815-756-4875
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