Individual
MRS. ELAINE A HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
137 E COLLEGE ST, KEWANEE, IL 61443
(309) 852-4331
Mailing address
100 S COLLEGE AVE, GENESCO, IL 61254
(309) 944-3203
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180 001100
IL
Other
Enumeration date
11/27/2007
Last updated
04/20/2009
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