Individual provider · Type 1 NPI

Nicole A. Stockburger

Mental Health Counselor · Bloomington, IL

NPI number 1629289616 Active

Practice location

108 W Market St
Bloomington, IL 61701-3918

Call (309) 827-5351 Map

Fax (309) 829-6808

Mailing address

427 Rinney Dr
Normal, IL 61761-4396

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1629289616

Nicole A. Stockburger's National Provider Identifier is 1629289616, issued on May 24, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bloomington, IL. The record was last updated on Jul 8, 2007.