Individual provider · Type 1 NPI

Jacqueline Renee Mathias

Mental Health Counselor · Bloomington, IL

NPI number 1609978485 Active

Practice location

108 W Market St
Bloomington, IL 61701-3918

Call (309) 827-5351 Map

Fax (309) 829-6806

Mailing address

1312 Eastholme Ave
Bloomington, IL 61701-1932

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1609978485

Jacqueline Renee Mathias's National Provider Identifier is 1609978485, issued on Sep 2, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bloomington, IL. The record was last updated on Jul 8, 2007.