Individual
AMY LYNN HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA,CADC, GCE
Contact information
Practice address
3248 VANDEVER AVE, PEKIN, IL 61554-6257
(309) 347-5579
(309) 347-4264
Mailing address
3248 VANDEVER AVE, PEKIN, IL 61554-6257
(309) 347-5579
(309) 347-4264
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25397
IL
Other
Enumeration date
12/16/2010
Last updated
12/16/2010
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