ALYSSA L PARK

SPRINGFIELD, IL
NPI1891039541
Former NameALYSSA L FAGAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: IL  180008205)
Enumeration Date2012-11-19
Last Update Date2013-10-11
Business Address
-- ALYSSA L PARK LCPC
5220 S 6TH STREET RD SUITE 2400
SPRINGFIELD, IL 62703-5735
Phone number: 217-757-7700
Mailing Address
-- ALYSSA L PARK LCPC
710 N 8TH ST
SPRINGFIELD, IL 62702-6324
Phone number: 217-525-1064