Organization
HERBOTH THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY HERBOTH MS, LCPC, NCC (OWNER)
(217) 259-2827
Entity
Organization
Contact information
Practice address
477 COUNTY ROAD 100 N, MONTROSE, IL 62445-3019
(217) 259-2827
(217) 280-4323
Mailing address
PO BOX 453, TEUTOPOLIS, IL 62467-0453
(217) 259-2827
(217) 280-4323
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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