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General NPI Number Information
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NPI Number | 1073680765
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Entity Type | Organization
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Legal Business Name | OPTIONS EAP
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 300 BACKBONE ROAD E SUITE 3
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City | PRINCETON
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State | IL
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Zip | 61356-2073
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Country | US
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Telephone | 815-879-0327
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Fax | 815-875-1720
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Provider Business Mailing Address
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Address Line | PO BOX 116
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City | PRINCETON
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State | IL
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Zip | 61356-0116
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Country | US
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Telephone | 815-879-0327
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Fax | 815-875-1720
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. TERRYANN DUMYAHN
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Credential | L.C.S.W.
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Telephone | 815-879-0327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149006773
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License Number State | IL
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