Individual
ELLA MARIE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 308-2030
(309) 308-2031
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 308-2030
(309) 308-2031
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.006423
IL
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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