person
Jody Marie Ideran
Mental Health Counselor in Bloomington, Illinois
NPI 1174619043

Jody Marie Ideran is a Mental Health Counselor based in Bloomington, IL and is specialized in Mental Health. Jody Marie Ideran practices in Bloomington, IL. The NPI Number for Jody Marie Ideran is 1174619043 and holds a License No. (Illinois).

The current practice location address for Jody Marie Ideran is 108 W Market St, Bloomington, IL and can be reached out via phone at 309-827-5351 and via fax at 309-829-6808. You can also correspond with Jody Marie Ideran through the mailing address at 11 PALM CT, BLOOMINGTON, IL - 61701-7849 (mailing address contact number: 309-275-4260).

Location: 108 W Market St, Bloomington, IL, 61701-7849
person
Provider Profile Details
NPI Number
1174619043
Provider Name
Jody Marie Ideran
Credential
Provider Entity Type
Individual
Gender
Female
Address
108 W Market St, Bloomington, IL, 61701-7849
Phone Number
309-827-5351
Fax Number
309-829-6808
Provider Enumeration Date
10/05/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
108 W Market St
City
State
Zip
61701-3918
Phone Number
309-827-5351
Fax Number
309-829-6808
person
Provider Business Mailing Address Details
Address
11 Palm Ct
City
State
Zip
61701-7849
Phone Number
309-275-4260
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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