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Individual

DAVID MINGUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
3248 VANDEVER AVE, PEKIN, IL 61554-6257
(309) 347-5579
(309) 347-4264
Mailing address
3248 VANDEVER AVE, PEKIN, IL 61554-6257
(309) 347-5579
(309) 347-4264

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180003321
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180003321
LCPC
IL
Enumeration date
10/15/2012
Last updated
10/15/2012
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