Individual
MS. TONYA RENAE CAMACHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCP
Contact information
Practice address
3205 W KENWOOD AVE, WEST PEORIA, IL 61604-4827
(309) 678-7030
Mailing address
3205 W KENWOOD AVE, WEST PEORIA, IL 61604-4827
(309) 678-7030
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.007311
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
180.007311
IL
101YM0800X
Mental Health Counselor
180.007311
—
101YP2500X
Professional Counselor
180.007311
—
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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