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1780693515
KIM HASTY
MARYVILLE, IL
NPI
1780693515
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 180-001216)
Enumeration Date
2006-08-08
Last Update Date
2007-07-08
Business Address
-- KIM HASTY M.S., LCPC
20 PROFESSIONAL PARK DR # A
MARYVILLE, IL 62062-5669
Phone number: 618-288-8787
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Mailing Address
-- KIM HASTY M.S., LCPC
20 PROFESSIONAL PARK DR # A
MARYVILLE, IL 62062-5669
Phone number: 618-288-8787
Copy
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