| 29:11 Healing Harbor, Pllc | |
|
450 E Market St Ste B Somonauk IL 60552-3230 | |
| (630) 708-0392 | |
| Not Available |
| Full Name | 29:11 Healing Harbor, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 450 E Market St Ste B, Somonauk, Illinois |
| Authorized Official Name and Position | Jessica L Novak (OWNER/THERAPIST) |
| Authorized Official Contact | 6307080392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 29:11 Healing Harbor, Pllc Po Box 224 Somonauk IL 60552-0224 Ph: (630) 708-0392 | 29:11 Healing Harbor, Pllc 450 E Market St Ste B Somonauk IL 60552-3230 Ph: (630) 708-0392 |
| NPI Number | 1598515025 |
|---|---|
| Provider Enumeration Date | 03/26/2024 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598515025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |