Provider Information for 1801238365
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ALISA CATES LCPC
Sex: Female
NPI: 1801238365
Last Updated: 2020-04-07
Certification Date: 2020-04-07
Certification Date: 2020-04-07
Details
Name | Value | ||||||||||||
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NPI | 1801238365 | ||||||||||||
Enumeration Date | 2013-07-25 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | YES | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 108 HAWTHORNE PL APT 2 COLUMBIA, IL 62236-1029 United States Phone: 618-340-1721 | Fax: | ||||||||||||
Primary Practice Address | 808 S MAIN ST STE C COLUMBIA, IL 62236-2499 United States Phone: 618-340-1721 | Fax: | ||||||||||||
Secondary Practice Address(es) | 988 N ILLINOIS ROUTE 3 | ||||||||||||
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