Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 178.012821 | FL |
NPI | 1003437450 |
---|---|
Provider Name | Adriana J Butcher |
First Address | Chicago, IL 60639-3136 |
Second Address | Chicago, IL 60639-3136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2020 |
Last Update Date | 27/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
178.012821 | LICENSED PROFESSIONAL COUNSELOR (01) | IL |