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1619121373
JACQUELYN A MITRA
NORMAL, IL
NPI
1619121373
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 180 006966)
Enumeration Date
2008-11-07
Last Update Date
2010-02-01
Business Address
Mrs. JACQUELYN A MITRA LCPC
405 KAYS DR SUITE B
NORMAL, IL 61761-1979
Phone number: 309-862-0064
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Mailing Address
Mrs. JACQUELYN A MITRA LCPC
405 KAYS DR SUITE B
NORMAL, IL 61761-1979
Phone number: 309-862-0064
Copy
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