Individual
CARLA ELAINE BAHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 S JOHNSON ST, MACOMB, IL 61455-2134
(309) 833-2008
(309) 213-9451
Mailing address
7693 E STATE ROUTE 95, SMITHFIELD, IL 61477-9481
(309) 338-5874
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
180.011337
IL
101YM0800X
Mental Health Counselor
Primary
180.011337
IL
101YP2500X
Professional Counselor
180.011337
IL
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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