Individual
HARON DENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
88 S MAIN ST STE 2, GLEN CARBON, IL 62034-1415
(618) 288-8085
Mailing address
PO BOX 639, GLEN CARBON, IL 62034-0639
(618) 288-8085
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
270000211
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270000211
STATE OF ILLINOIS LICENSE
IL
Enumeration date
07/11/2019
Last updated
07/11/2019
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