29:11 Healing Harbor, Pllc | |
450 E Market St Ste B Somonauk IL 60552-3230 | |
(630) 708-0392 | |
Not Available |
Full Name | 29:11 Healing Harbor, Pllc |
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Speciality | Social Worker - Clinical |
Location | 450 E Market St Ste B, Somonauk, Illinois |
Authorized Official Name and Position | Jessica L Novak (OWNER/THERAPIST) |
Authorized Official Contact | 6307080392 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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29:11 Healing Harbor, Pllc Po Box 224 Somonauk IL 60552-0224 Ph: (630) 708-0392 | 29:11 Healing Harbor, Pllc 450 E Market St Ste B Somonauk IL 60552-3230 Ph: (630) 708-0392 |
NPI Number | 1598515025 |
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Provider Enumeration Date | 03/26/2024 |
Last Update Date | 03/28/2024 |
Certification Date | 03/28/2024 |
Identifier | Type | State | Issuer |
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1598515025 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |