Individual
JAYSHREE PANCHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC, NCC
Contact information
Practice address
7210 N VILLA LAKE DR STE C, PEORIA, IL 61614-8290
(309) 713-1485
(309) 419-4328
Mailing address
7210 N VILLA LAKE DR STE C, PEORIA, IL 61614-8290
(309) 713-1485
(309) 419-4328
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.010474
IL
Other
Enumeration date
02/24/2014
Last updated
09/18/2020
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