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Individual

JOANNA MARIE DY DE LEON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LCPC

Contact information

Practice address
4615 E STATE ST STE 204, ROCKFORD, IL 61108-2158
(815) 708-9068
(779) 970-5908
Mailing address
4615 E STATE ST STE 204, ROCKFORD, IL 61108-2158
(815) 708-9068

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
178014740
IL
101YP2500X
Professional Counselor
180014142
IL
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
11/27/2019
Last updated
04/30/2024
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