Individual
MRS. CHRISTIAN ANN MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
4703 44TH ST, ROCK ISLAND, IL 61201
(309) 788-9581
(309) 786-3856
Mailing address
4703 44TH ST, ROCK ISLAND, IL 61201-7189
(309) 788-9581
(309) 786-3856
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.012423
IL
101YP2500X
Professional Counselor
180011594
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178012423
STATE OF ILLINOIS PROFESSIONAL LICENSE
IL
01
—
180011594
STATE OF ILLINOIS LICENSED CLINICAL PROFESSIONAL COUNSELOR
IL
Enumeration date
12/04/2017
Last updated
06/28/2018
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