Individual
DR. JUVENAL GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
701 DEVONSHIRE DR, SUITE 203C BLDG C, CHAMPAIGN, IL 61820
(708) 381-0445
Mailing address
701 DEVONSHIRE DR., PO BOX C-3, CHAMPAIGN, IL 61820
(708) 381-0445
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
071010536
IL
Other
Enumeration date
08/26/2013
Last updated
08/04/2022
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