Facts
- Status
- A
- Credential
- LMFT
- Type
- Individual
- Enumeration date
- 2019-07-08
- Last updated
- 2019-07-08
Specialties
Licenses
- License IL
- 166.001293
Location
- Practice location
- 460 WINNETKA AVE
- City
- WINNETKA IL
- Postal code
- 600934206
- Phone
- 847-630-5238
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.