Glen Manor Counseling

NPI #1972604411 in Peoria, Illinois

Provider Information

NPI Number: 1972604411
Entity Type: Organization
Organization Name: Glen Manor Counseling
Primary Specialty: Psychologist
Enumeration Date: Sep 26, 2006
Last Updated: Jun 19, 2008

Practice Location

Address: 914 GLEN AVE
Address 2: SUITE #3
City: Peoria
State: Illinois
ZIP Code: 61614
Phone: (309) 693-2749

Authorized Official

Name: MRS. JULIE A RAY, LCSW
Title: PRESIDENT OWNER
Phone: (309) 693-2749

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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