Individual
ALYSSA L PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5220 S 6TH STREET RD, SUITE 2400, SPRINGFIELD, IL 62703-5735
(217) 757-7700
(217) 757-7799
Mailing address
710 N 8TH ST, SPRINGFIELD, IL 62702-6324
(217) 525-1064
(217) 525-1651
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180008205
IL
Other
Enumeration date
11/19/2012
Last updated
10/11/2013
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