Individual
JEANETTE W GEORGEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA, LCPC, ATR
Contact information
Practice address
10314 LINCOLN TRL, SUITE 101, FAIRVIEW HEIGHTS, IL 62208-1801
(618) 394-8952
(618) 394-8952
Mailing address
10314 LINCOLN TRL, SUITE 101, FAIRVIEW HEIGHTS, IL 62208-1801
(618) 394-8952
(618) 394-8952
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97-084
ATR
—
Enumeration date
06/01/2006
Last updated
07/08/2007
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