Organization
ADVANCED BEHAVIORAL HEALTH P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA LYNNE ROGERS PSY.D. (PRESIDENT CLINICAL PSYCHOLOGIST)
(309) 648-9587
Entity
Organization
Contact information
Practice address
8600 ROUTE 91, NORTH, SUITE 240, PEORIA, IL 61615
(309) 683-5094
(309) 683-5095
Mailing address
20607 N FAWN CT, CHILLICOTHE, IL 61523-9761
(309) 648-9587
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
05/03/2007
Last updated
08/27/2007
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