Individual
MRS. BRENDA I BEANBLOSSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LCPC
Contact information
Practice address
320 SOUTH LOCUST STREET, CARLINVILLE, IL 62626
(217) 854-3166
(217) 854-9729
Mailing address
320 SOUTH LOCUST STREET, CARLINVILLE, IL 62626
(217) 854-3166
(217) 854-9729
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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