Individual
ANGELA E JANCOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
411 E PARK ST STE 106, CHAMPAIGN, IL 61820-3862
(217) 714-7042
Mailing address
19 LAKE PARK RD, CHAMPAIGN, IL 61822-7132
(217) 493-6193
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
149.022802
IL
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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