Jared G Deerhake, BS MHP Valid NPI
Individual provider · Counselor · Centralia, IL
- NPI
- 1790135796
- Type
- Individual (Type 1)
- Primary specialty
- Counselor
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 101Y00000X
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2016-06-21
- Last updated
- 2016-06-21
Practice location
904 E. Martin Luther King Dr.
Centralia, IL 62801-3058
(618) 533-1391