Organization
BRYAN MANION, LIFE COACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN MYLES MANION (OWNER)
(217) 474-8455
Entity
Organization
Contact information
Practice address
206 N RANDOLPH ST, CHAMPAIGN, IL 61820-3949
(217) 474-8455
Mailing address
PO BOX 934, CHAMPAIGN, IL 61824-0934
(217) 474-8455
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.006836
IL
101YP2500X
Professional Counselor
180.006836
IL
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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