Organization
PRAIRIE RIVER COUNSELING AND CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY THERESE BOYLE LCSW (MANAGER)
(815) 304-4948
Entity
Organization
Contact information
Practice address
310 N CONVENT ST, SUITE 3, BOURBONNAIS, IL 60914-2099
(815) 304-4948
Mailing address
310 N CONVENT ST, SUITE 3, BOURBONNAIS, IL 60914-2099
(815) 304-4948
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149018807
IL
Other
Enumeration date
01/27/2017
Last updated
02/22/2017
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