Donaldson, Jessica

Donaldson, Jessica is an sole proprietor health care provider with primary practice located at 2323 Windish Dr , Galesburg IL 61401-9780. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Donaldson, Jessica can be contacted via phone (309) 344-2323.

Contact Information

Primary practice address
2323 Windish Dr Galesburg IL 61401-9780
Phone: (309) 344-2323
Fax: (309) 344-4281
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 166.001015 Illinois

Profile Details

NPI number 1174982417
LBN Legal business name Donaldson, Jessica
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 15th, 2016
Last updated Feb 15th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174982417 NPPES
Illinois MEDICAID 370984175-006

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