Jisun Park, B.A.

NPI #1386945459 in Mattoon, Illinois

Provider Information

NPI Number: 1386945459
Entity Type: Individual
Name: Jisun Park, B.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: B.A.
Enumeration Date: Nov 5, 2010
Last Updated: Nov 5, 2010

Practice Location

Address: 750 BROADWAY AVE E
City: Mattoon
State: Illinois
ZIP Code: 61938-4610
Phone: (217) 238-5700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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