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Individual

AMANDA ROUSONELOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2611 WOODLAWN RD, STERLING, IL 61081-4151
(815) 625-0013
Mailing address
14047 IL HIGHWAY 40, BUDA, IL 61314-9473
(815) 878-1097

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178.011008
IL
101YM0800X
Mental Health Counselor
Primary
180015789
IL

Other

Enumeration date
05/08/2018
Last updated
01/23/2024
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