Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 180009207 | IL |
NPI | 1003345448 |
---|---|
Provider Name | Elianna Barrios |
First Address | Bolingbrook, IL 60440-2391 |
Second Address | Bolingbrook, IL 60440-2391 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2017 |
Last Update Date | 17/03/2018 |