Individual
JULIE ALYCE CHASTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, NCC
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(217) 412-4090
Mailing address
650 JOEL DR BLDG 698830TH, FORT CAMPBELL, KY 42223-5318
(270) 956-4112
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180003273
IL
Other
Enumeration date
04/03/2007
Last updated
03/28/2019
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