Provider Information for 1588075048
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Ms. MARY JENNIFER SUE MEISTER LCSW
Sex: Female
NPI: 1588075048
Last Updated: 2019-12-19
Certification Date: 2019-12-19
Certification Date: 2019-12-19
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1588075048 | ||||||||
| Enumeration Date | 2014-05-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2214 N UNIVERSITY ST PEORIA, IL 61604-3221 United States Phone: 309-680-7669 | Fax:309-681-8443 | ||||||||
| Primary Practice Address | 2321 N WISCONSIN AVE PEORIA, IL 61603-5613 United States Phone: 309-680-7600 | Fax:309-681-4681 | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|