Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 178.012924 | IL |
N | 101YS0200X | School Counselor | 2059887 | IL |
NPI | 1073049268 |
---|---|
Provider Name | Felicity Dineen |
First Address | Chicago, IL 60647-3154 |
Second Address | Willowbrook, IL 60527-7607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2017 |
Last Update Date | 27/07/2017 |