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Individual

JACOB HOLTHOFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
201 W SPRINGFIELD AVE STE 1201, CHAMPAIGN, IL 61820-6385
(217) 722-9079
(217) 501-4322
Mailing address
201 W SPRINGFIELD AVE STE 1201, CHAMPAIGN, IL 61820-6385
(217) 722-9079

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178018951
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1063150175
IL
Enumeration date
05/27/2022
Last updated
01/18/2025
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