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Individual

GEORGE P SPANGLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.P.C.

Contact information

Practice address
3815 HARRISON AVE, ROCKFORD, IL 61108-7631
(815) 391-1000
(815) 391-5040
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
(815) 387-5600

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178-006109
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
166880
C.A.D.C
IL
01
27537
M.A.A.T.P.
IL
Enumeration date
02/07/2012
Last updated
02/07/2012
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