Individual
JO SACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
6615 N BIG HOLLOW RD, PEORIA, IL 61615-2450
(309) 692-6622
Mailing address
6615 N BIG HOLLOW RD, PEORIA, IL 61615-2450
(309) 692-6622
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180004604
IL
Other
Enumeration date
08/01/2006
Last updated
11/16/2012
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