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Individual

MARK ALLEN HERIFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, CADC

Contact information

Practice address
121 N LAKE DR, ATLANTA, IL 61723-8819
(913) 645-3587
Mailing address
702 W CHESTNUT ST, BLOOMINGTON, IL 61701-2814
(309) 557-1400

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.021648
IL

Other

Enumeration date
05/14/2025
Last updated
05/14/2025
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