Most Relevant Information
Provider Data
| NPI Number: | 1003553470 |
| Provider Name: | ALEXIS HEROD |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/17/2022 |
| Last Updated: | 05/17/2022 |
Provider Practice Location
304 N 6TH ST
DEKALB
IL
601153484
Practice Location Phone/Fax
| Phone: | 8153755261 |
| Fax: |
Provider Mailing Location
304 N 6TH ST
DEKALB
IL
601153484
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |