Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003194051 |
---|---|
Provider Name | Mrs. Jamie Renee Meagher |
First Address | Danville, IL 61832-5410 |
Second Address | Danville, IL 61832-5410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2011 |
Last Update Date | 25/07/2011 |