Individual provider · Type 1 NPI

Jacquelyn A. Mitra, LCPC

Mental Health Counselor · Normal, IL

NPI number 1619121373 Active

About NPI 1619121373

Jacquelyn A. Mitra, LCPC's National Provider Identifier is 1619121373, issued on Nov 7, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Normal, IL. The record was last updated on Feb 1, 2010.