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1174572333
THERESA MAI DITCHFIELD
MATTOON, IL
NPI
1174572333
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Former Name
THERESA DITCHFIELD
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NC C005169)
Enumeration Date
2006-05-08
Last Update Date
2011-01-12
Business Address
-- THERESA MAI DITCHFIELD LCSW
717 N 21ST ST
MATTOON, IL 61938-2705
Phone number: 910-987-9296
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Mailing Address
-- THERESA MAI DITCHFIELD LCSW
717 N 21ST ST
MATTOON, IL 61938-2705
Phone number: 910-987-9296
Copy
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