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1851904874
THECLA A GAVIN
PEORIA, IL
NPI
1851904874
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 178.016210)
Enumeration Date
2020-08-28
Last Update Date
2020-08-28
Business Address
THECLA A GAVIN MAC, NCC, LPC
330 SW WASHINGTON ST
PEORIA, IL 61602-1406
Phone number: 309-676-2400
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Mailing Address
THECLA A GAVIN MAC, NCC, LPC
330 SW WASHINGTON ST
PEORIA, IL 61602-1406
Phone number: 309-676-2400
Copy
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