Doctor Name: | MS. SHARON COLLEEN MEYER |
NPI Number: | 1093838096 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BS CADC |
License Number: | 21344 |
Business Practice Address: | 101 S Locust St Centralia, IL - 628013506 |
Business Phone Number: | 6185331391 |
Business Fax Number: | |
Mailing Address: | 23173 Il Rt 185, MULBERRY GROVE |
State: | IL |
Postal Code: | 622623136 |
Phone Number: | 6183268817 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 21344 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |