Individual
IMANI TALIAH HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
701 DEVONSHIRE DR STE C19, CHAMPAIGN, IL 61820-7352
(309) 431-5381
Mailing address
607 E TOMARAS AVE, SAVOY, IL 61874-9418
(217) 255-0346
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180014137
IL
101YP2500X
Professional Counselor
178.014231
IL
101YP2500X
Professional Counselor
180.014137
IL
Other
Enumeration date
10/23/2018
Last updated
02/17/2022
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