Individual
MS. JENNIFER L GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1801 FOX DR, CHAMPAIGN, IL 61820-7236
(217) 398-8080
Mailing address
405 W PARK ST APT 7, URBANA, IL 61801-1651
(630) 306-2804
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
10/16/2010
Last updated
10/16/2010
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