Individual
DANIELLE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, NCC, LPC
Contact information
Practice address
205 N WILLIAMSBURG DR STE A, BLOOMINGTON, IL 61704-7721
(309) 807-5077
Mailing address
312 S EMERY ST, HEYWORTH, IL 61745-9202
(309) 531-6107
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.018809
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
IL
Enumeration date
01/13/2023
Last updated
01/13/2023
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