Doctor Name: | MRS. ALLISON G. PARKS JOHNSEN |
NPI Number: | 1245214154 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LCPC |
License Number: | |
Business Practice Address: | 106 W Pierce St Elburn, IL - 601198201 |
Business Phone Number: | 6303650899 |
Business Fax Number: | 6303659150 |
Mailing Address: | 3127 Renard Ln, SAINT CHARLES |
State: | IL |
Postal Code: | 601754653 |
Phone Number: | 6303771976 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2005 |
NPI Last Update Date: | 02/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |