Provider Information for 1245847359
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SHARIECE INEZ HASTINGS MS,CRC,LCPC
Other Names:Former Name:SHARIECE INEZ THOMPSON MS,CRC,LCPCSex: Female
NPI: 1245847359
Last Updated: 2020-09-23
Certification Date: 2020-09-23
Certification Date: 2020-09-23
Details
| Name | Value | ||||||||
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| NPI | 1245847359 | ||||||||
| Enumeration Date | 2020-09-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 904 E CINDY ST CARBONDALE, IL 62901-3318 United States Phone: 618-203-1574 | Fax: | ||||||||
| Primary Practice Address | 904 E CINDY ST CARBONDALE, IL 62901-3318 United States Phone: 618-203-1574 | Fax: | ||||||||
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