Individual
MR. JASON ANDREW PECKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.ED., L.P.C.
Contact information
Practice address
433 PHELPS AVE, SUITE #2, ROCKFORD, IL 61108-2442
(815) 397-4287
Mailing address
2506 BURRMONT RD, ROCKFORD, IL 61107-1842
(414) 801-7905
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180005895
IL
101YP2500X
Professional Counselor
3938-125
WI
Other
Enumeration date
04/07/2008
Last updated
07/16/2014
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