Provider Information for 1790089548
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Ms. KRISTINE R DONALDSON LCSW
Sex: Female
NPI: 1790089548
Last Updated: 2024-10-14
Certification Date: 2024-10-14
Certification Date: 2024-10-14
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1790089548 | ||||||||||||
| Enumeration Date | 2011-01-07 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 519 N WILLIAM ST FARMER CITY, IL 61842-1123 United States Phone: 217-871-6993 | Fax: | ||||||||||||
| Primary Practice Address | 519 N WILLIAM ST FARMER CITY, IL 61842-1123 United States Phone: 217-871-6993 | Fax: | ||||||||||||
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