Most Relevant Information
Provider Data
NPI Number: | 1003530395 |
Provider Name: | JENNIFER CARLETON LPC |
Entity Type: | Individual |
Taxonomy Code: | 101YP2500X |
Specialty: | Counselor |
License Number: | 178018284 |
Most Important Dates
Enumeration Date: | 09/29/2022 |
Last Updated: | 09/29/2022 |
Provider Practice Location
411 DEVONSHIRE DR
CHAMPAIGN
IL
618207286
Practice Location Phone/Fax
Phone: | 2179043035 |
Fax: |
Provider Mailing Location
411 DEVONSHIRE DR
CHAMPAIGN
IL
618207286
Provider Mailing Phone/Fax
Phone: | 2179043035 |
Fax: |