Individual
MRS. BRENDA ANN MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
747 E ETNA RD, OTTAWA, IL 61350-3777
(815) 993-1614
Mailing address
1317 FLAGG RD, DIXON, IL 61021-8949
(815) 677-6650
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
26644
IL
101YP2500X
Professional Counselor
Primary
180.010067
IL
Other
Enumeration date
01/23/2008
Last updated
09/20/2016
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