Individual
AMY C CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1115 FRONTAGE RD STE B, O FALLON, IL 62269-2093
(618) 792-5200
Mailing address
1115 FRONTAGE RD STE B, O FALLON, IL 62269-2093
(618) 792-5200
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180006300
IL
Other
Enumeration date
01/06/2007
Last updated
09/16/2021
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