DR. Tara Carlotta Fasol, LCPC

NPI #1265120554 in West Frankfort, Illinois

Provider Information

NPI Number
1265120554
Entity Type
Individual
Name
DR. Tara Carlotta Fasol, LCPC
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Professional
Credential
LCPC
Enumeration Date
Apr 25, 2023
Last Updated
Apr 25, 2023

Practice Location

Address
218 E MAIN ST
ZIP Code
62896-2406
Phone
(618) 242-6944

Specialties & Taxonomy Codes

Specialty
Counselor - ProfessionalProfessional

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