Individual
MR. JASON CHRISTOPHER EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1307 W MAIN ST, MARION, IL 62959-1139
(618) 997-5336
(618) 993-2969
Mailing address
401 N MAIN ST, ANNA, IL 62906-1620
(618) 997-5336
(618) 993-2969
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.003427
IL
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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