Individual
JONATHAN ERIC BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 S 24TH ST, QUINCY, IL 62301-4492
(217) 592-0449
Mailing address
205 S 24TH ST, QUINCY, IL 62301-4492
(217) 592-0449
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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