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Individual

JASON WOODFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
6615 N BIG HOLLOW RD, PEORIA, IL 61615-2450
(309) 692-6952
(309) 692-6952
Mailing address
320 S MARION ST, MOUNT PULASKI, IL 62548-1322
(815) 421-3175

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.011531
IL

Other

Enumeration date
05/22/2015
Last updated
12/09/2024
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