FIDEL PONCE

DEKALB, IL
NPI1487353660
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2023-02-27
Last Update Date2023-02-27
Business Address
FIDEL PONCE BA
12 HEALTH SERVICES DR
DEKALB, IL 60115-9637
Phone number: 815-756-4875
Mailing Address
FIDEL PONCE BA
PO BOX 1109
DEKALB, IL 60115-7109
Phone number: 815-756-4875
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