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1891039541
ALYSSA L PARK
SPRINGFIELD, IL
NPI
1891039541
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Former Name
ALYSSA L FAGAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: IL 180008205)
Enumeration Date
2012-11-19
Last Update Date
2013-10-11
Business Address
ALYSSA L PARK LCPC
5220 S 6TH STREET RD SUITE 2400
SPRINGFIELD, IL 62703-5735
Phone number: 217-757-7700
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Mailing Address
ALYSSA L PARK LCPC
710 N 8TH ST
SPRINGFIELD, IL 62702-6324
Phone number: 217-525-1064
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