Individual
VICKIE Y BEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 S JOHNSON ST, MACOMB, IL 61455-2134
(309) 833-2008
Mailing address
103 S JOHNSON ST, MACOMB, IL 61455-2134
(309) 833-2008
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
178.007584
IL
Other
Enumeration date
04/15/2011
Last updated
11/30/2011
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