Jody Marie Ideran
NPI #1174619043 in Bloomington, Illinois
Provider Information
- NPI Number
- 1174619043
- Entity Type
- Individual
- Name
- Jody Marie Ideran
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Oct 5, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 108 W MARKET ST
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61701-3918
- Phone
- (309) 827-5351
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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