Individual
MR. ETHAN JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
802 N 8TH ST, VANDALIA, IL 62471-1756
(618) 283-1731
Mailing address
320 N 2ND ST, VANDALIA, IL 62471-2351
(217) 821-9434
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178011650
IL
101YP2500X
Professional Counselor
Primary
180011408
IL
Other
Enumeration date
05/31/2017
Last updated
07/21/2022
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