Individual
AUTUMN LLOYD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
75 E QUEENWOOD RD, MORTON, IL 61550-2985
(309) 263-5565
(309) 263-9336
Mailing address
75 E QUEENWOOD RD, MORTON, IL 61550-2985
(309) 263-5565
(309) 263-9336
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
178011554
IL
101Y00000X
Counselor
Primary
180.010282
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178011554
LICENSE
IL
Enumeration date
01/08/2016
Last updated
05/04/2016
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