Individual
KEVIN BUSHUR
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS/LCPC
Contact information
Practice address
1200 N 4TH ST, EFFINGHAM, IL 62401-3032
(217) 347-7179
Mailing address
17454 N 1400TH ST, EFFINGHAM, IL 62401-6707
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
Other
Enumeration date
08/10/2005
Last updated
07/08/2007
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