Individual
MRS. DEBORAH J. MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
7150 N UNIVERSITY ST, PEORIA, IL 61614-1752
(309) 691-2089
(309) 691-2089
Mailing address
7150 N UNIVERSITY ST, PEORIA, IL 61614-1752
(309) 691-2089
(309) 691-2089
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180-000343
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030383637
EMPLOYEE IDENTIFICATION
IL
Enumeration date
04/11/2006
Last updated
05/16/2011
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