Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1043427511 |
---|---|
Provider Name | Megan Lynn Foreman |
First Address | Champaign, IL 61820-3929 |
Second Address | Champaign, IL 61820-3929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 23/04/2012 |