Individual
MRS. SHIRLEY GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1307 W MAIN ST, MARION, IL 62959-1139
(618) 997-5336
(618) 993-2969
Mailing address
7431 STATE RTE 154, TAMAROA, IL 62888-2459
(618) 997-5336
(618) 993-2969
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
149.013421
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
149.013421
IL
101YM0800X
Mental Health Counselor
149.013421
IL
Other
Enumeration date
04/12/2010
Last updated
04/12/2010
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