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Individual

NEALA AUSMUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.C.P.C.,R.D.

Contact information

Practice address
3000 PROFESSIONAL DR, SPRINGFIELD, IL 62703-5931
(217) 793-9593
(217) 793-6949
Mailing address
3000 PROFESSIONAL DR STE A, SPRINGFIELD, IL 62703-5943
(217) 793-9593
(217) 793-6949

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180005285
IL

Other

Enumeration date
04/27/2008
Last updated
04/27/2008
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