Tim Carrasca

NPI #1619000742 in Bloomington, Illinois

Provider Information

NPI Number: 1619000742
Entity Type: Individual
Name: Tim Carrasca
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Mar 14, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1003 MARTIN LUTHER KING DR
City: Bloomington
State: Illinois
ZIP Code: 61701-1429
Phone: (309) 827-6026

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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