Individual provider · Type 1 NPI

Jisun Park, B.A.

Mental Health Counselor · Mattoon, IL

NPI number 1386945459 Active

Practice location

750 Broadway Ave E
Mattoon, IL 61938-4610

Call (217) 238-5700 Map

Fax (217) 238-5767

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1386945459

Jisun Park, B.A.'s National Provider Identifier is 1386945459, issued on Nov 5, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Mattoon, IL. The record was last updated on Nov 5, 2010.