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1083169965
JASON DEFORD
PEORIA, IL
NPI
1083169965
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 180010119)
Enumeration Date
2016-08-19
Last Update Date
2016-08-19
Business Address
-- JASON DEFORD LCPC
3020 W WILLOW KNOLLS DR
PEORIA, IL 61614-8127
Phone number: 309-681-5652
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Mailing Address
-- JASON DEFORD LCPC
3020 W WILLOW KNOLLS DR
PEORIA, IL 61614-8127
Phone number: 309-681-5652
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