Individual
HEATHER O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, HSPP
Contact information
Practice address
808 S ELDORADO RD, SUITE 102, BLOOMINGTON, IL 61704-6071
(309) 706-3190
(309) 588-4115
Mailing address
1801 WINDSOR RD, SUITE 2617, CHAMPAIGN, IL 61822-6217
(217) 693-6072
(309) 588-4115
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20042680A
IN
Other
Enumeration date
04/09/2013
Last updated
12/04/2014
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