Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 178013790 | IL |
NPI | 1003387267 |
---|---|
Provider Name | Heather Bell |
First Address | Chicago, IL 60608-4197 |
Second Address | Chicago, IL 60602-3844 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2018 |
Last Update Date | 05/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
180012721 | LCPC (01) | IL |