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General NPI Number Information
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NPI Number | 1013772748
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Entity Type | Organization
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Legal Business Name | TURN ON THE LIGHT THERAPY SERVICES, PLLC
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 4006 PINECREST DR
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City | CHAMPAIGN
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State | IL
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Zip | 61822-9216
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Country | US
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Telephone | 217-552-7964
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 379
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City | SAVOY
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State | IL
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Zip | 61874-0379
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Country | US
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Telephone | 217-552-7964
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | MRS. ERICA TONN
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Credential |
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Telephone | 217-552-7964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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