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Organization
LIFE BALANCE
Active
Organization
LIFE BALANCE
Active
Parent organization
ROBERT TUTT
Other names
Robert Tutt
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROBERT TUTT
Authorized official
MR. ROBERT CHARLES TUTT LCPC (OWNER)
(815) 978-4749
Entity
Organization
Contact information
Practice address
5301 E STATE ST, SUITE 203, ROCKFORD, IL 61108-2901
(815) 978-4749
Mailing address
PO BOX 589, KIRKLAND, IL 60146-0589
(815) 978-4749
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21746
IL
101YP2500X
Professional Counselor
Primary
180.006576
IL
Other
Enumeration date
07/11/2009
Last updated
07/11/2009
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