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Individual

AMANDA MARIE DILLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC, NCC

Contact information

Practice address
981 WHITECHAPEL DR, O FALLON, IL 62269-7270
(618) 700-0078
Mailing address
981 WHITECHAPEL DR, O FALLON, IL 62269-7270
(618) 700-0078

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.012816
IL
101YS0200X
School Counselor
2389769
IL

Other

Enumeration date
05/23/2020
Last updated
05/23/2020
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