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Individual

MISS JENA THOMASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
RR 1 BOX 277, LAWRENCEVILLE, IL 62439-9784
(618) 943-3754
(618) 943-3657
Mailing address
RR 1 BOX 277, LAWRENCEVILLE, IL 62439-9784
(618) 943-3754
(618) 943-3657

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37600178008
IL
Enumeration date
11/06/2007
Last updated
10/26/2009
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