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1881372308
CITIED
ROCKFORD, IL
NPI
1881372308
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Entity Type
Organization
Authorized Contact
ASHTON RAE LOCKHART
Sole Proprietor
608-713-3454
Organization Subpart ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2023-07-05
Last Update Date
2023-10-19
Business Address
CITIED
5301 E STATE ST STE 309A
ROCKFORD, IL 61108-2399
Phone number: 608-713-3454
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Mailing Address
CITIED
1907 JONATHAN AVE
ROCKFORD, IL 61103-2908
Phone number: 815-621-3853
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