Patricia A. Roosevelt LLC

NPI #1891288478 in Columbia, Illinois

Provider Information

NPI Number: 1891288478
Entity Type: Organization
Organization Name: Patricia A. Roosevelt LLC
Primary Specialty: Counselor - Professional
Enumeration Date: Jun 8, 2018
Last Updated: Jun 8, 2018

Practice Location

Address: 101 MCCROSKY PROFESSIONAL PARK
City: Columbia
State: Illinois
ZIP Code: 62236-2471
Phone: (618) 977-0734

Authorized Official

Name: MRS. PATRICIA A. ROOSEVELT, LCPC
Title: PRESIDENT
Phone: (618) 977-0734

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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