Southern Il Institute of Behavioral Health PC
NPI #1346562881 in Glen Carbon, Illinois
Provider Information
- NPI Number
- 1346562881
- Entity Type
- Organization
- Organization Name
- Southern Il Institute of Behavioral Health PC
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Feb 25, 2010
- Last Updated
- May 19, 2012
Practice Location
- Address
- 9 JUNCTION DR W
- Address 2
- SUITE 6
- City
- Glen Carbon
- State
- Illinois
- ZIP Code
- 62034-2931
- Phone
- (618) 710-4123
Authorized Official
- Name
- MRS. TRACY LYNN SASHIDHARAN, MA, NCC, LCPC
- Title
- TREASURER
- Phone
- (618) 710-4123
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
| Psychologist - Clinical — Clinical |
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