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1194337147
SHANE G. YOUNG
PEORIA, IL
NPI
1194337147
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 178015348)
Enumeration Date
2020-08-20
Last Update Date
2020-08-20
Business Address
SHANE G. YOUNG MA, NCC, LPC
3020 W WILLOW KNOLLS DR
PEORIA, IL 61614-8127
Phone number: 309-681-5850
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Mailing Address
SHANE G. YOUNG MA, NCC, LPC
PO BOX 335
GLASFORD, IL 61533-0335
Phone number: 309-202-4417
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