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Individual

AIMEE J CRASK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LCPC

Contact information

Practice address
1942 E CANTRELL ST, DECATUR, IL 62521-3214
(217) 423-6961
Mailing address
1942 E CANTRELL ST, DECATUR, IL 62521-3214
(217) 423-6961
(217) 421-6889

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180005810
IL
174400000X
Specialist
180005810
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180005810
LICENSED CLINICAL PROFESSIONAL COUNSELOR
IL
Enumeration date
09/27/2013
Last updated
11/17/2022
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