| Stone Bridge Counseling Llc | |
|
3526 N California Ave Ste 204 Peoria IL 61603-1164 | |
| (815) 408-0522 | |
| Not Available |
| Full Name | Stone Bridge Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3526 N California Ave Ste 204, Peoria, Illinois |
| Authorized Official Name and Position | Daniel Ryne Osterloo (COUNSELOR) |
| Authorized Official Contact | 3092519328 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stone Bridge Counseling Llc 418 W Michigan Ave Metamora IL 61548-9632 Ph: (309) 251-9328 | Stone Bridge Counseling Llc 3526 N California Ave Ste 204 Peoria IL 61603-1164 Ph: (815) 408-0522 |
| NPI Number | 1306464201 |
|---|---|
| Provider Enumeration Date | 07/08/2020 |
| Last Update Date | 07/08/2020 |
| Certification Date | 07/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306464201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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