Individual
FABIAN TASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.P.C.
Contact information
Practice address
3000 PROFESSIONAL DR STE A, SPRINGFIELD, IL 62703-5943
(217) 793-9593
(217) 793-6949
Mailing address
3000 PROFESSIONAL DR STE A, SPRINGFIELD, IL 62703-5943
(217) 793-9593
(217) 793-6949
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180002118
IL
Other
Enumeration date
04/27/2008
Last updated
04/27/2008
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