Individual
JESSA CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
3516 W HARMON HWY, PEORIA, IL 61604-5925
(309) 712-3962
Mailing address
3516 W HARMON HWY, PEORIA, IL 61604-5925
(309) 712-3962
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.016220
IL
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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