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Individual

KELLY JO BUSCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.A. M.H.P.

Contact information

Practice address
1200 N 4TH ST, EFFINGHAM, IL 62401-3032
(217) 347-7179
(217) 342-6716
Mailing address
PO BOX 1047, EFFINGHAM, IL 62401-1047
(217) 347-7179
(217) 342-6716

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
09/14/2011
Last updated
09/14/2011
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