Melissa Shane Counseling Services LLC

NPI #1083125298 in Peoria, Illinois

Provider Information

NPI Number
1083125298
Entity Type
Organization
Organization Name
Melissa Shane Counseling Services LLC
Primary Specialty
Community/Behavioral Health
Enumeration Date
Oct 14, 2017
Last Updated
Oct 14, 2017

Practice Location

Address
6919 N KNOXVILLE AVE STE 100
City
Peoria
ZIP Code
61614-2858
Phone
(309) 369-3498

Authorized Official

Name
MELISSA ANN SHANE, LCPC
Title
OWNER
Phone
(309) 369-3498

Specialties & Taxonomy Codes

Specialty
Community/Behavioral Health

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