Individual
GAYLA RENEA FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LCPC
Contact information
Practice address
4 INDUSTRIAL DR, FREEBURG, IL 62243-3229
(618) 402-7735
Mailing address
611 CAROL ANN DR, O FALLON, IL 62269-3435
(618) 402-7735
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180007036
IL
101YP2500X
Professional Counselor
Primary
180007036
IL
Other
Enumeration date
10/29/2008
Last updated
10/29/2008
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