person
Mrs. Jacquelyn A Mitra, LCPC
Mental Health Counselor in Normal, Illinois
NPI 1619121373

Jacquelyn A Mitra is a Mental Health Counselor based in Normal, IL and is specialized in Mental Health. Jacquelyn A Mitra practices in Normal, IL and has the professional credentials of LCPC. The NPI Number for Jacquelyn A Mitra is 1619121373 and holds a License No. 180 006966 (Illinois).

The current practice location address for Jacquelyn A Mitra is 405 Kays Dr, Normal, IL and can be reached out via phone at 309-862-0064 and via fax at 309-862-1542.

Location: 405 Kays Dr, Normal, IL, 61761-1979
person
Provider Profile Details
NPI Number
1619121373
Provider Name
Jacquelyn A Mitra
Credential
LCPC
Provider Entity Type
Individual
Gender
Female
Address
405 Kays Dr, Normal, IL, 61761-1979
Phone Number
309-862-0064
Fax Number
309-862-1542
Provider Enumeration Date
11/07/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
405 Kays Dr
City
State
Zip
61761-1979
Phone Number
309-862-0064
Fax Number
309-862-1542
person
Provider Business Mailing Address Details
Address
405 Kays Dr
City
State
Zip
61761-1979
Phone Number
309-862-0064
Fax Number
309-862-1542
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
180 006966 (Illinois)
Definition
Definition to come...
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