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Individual

MRS. CAROL JEAN COLLINS BURCHARDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
2440 CHARLES ST, SUITE 201, ROCKFORD, IL 61108-1654
(815) 289-7209
Mailing address
1403 CHARLOTTE CT, ROCKFORD, IL 61108
(815) 289-7209

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180 003390
IL

Other

Enumeration date
03/29/2007
Last updated
07/20/2009
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