Individual
MRS. COURTNEY DARLENE PENROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS MHP
Contact information
Practice address
408 E VINE ST, VIENNA, IL 62995-1612
(618) 658-2611
(618) 658-2501
Mailing address
408 E VINE ST, VIENNA, IL 62995-1612
(618) 658-2611
(618) 658-2501
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/24/2011
Last updated
02/24/2011
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