Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 180007539 | IL |
NPI | 1174804207 |
---|---|
Provider Name | Heather Klemm |
First Address | Elgin, IL 60123-6042 |
Second Address | Elgin, IL 60123-6042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2011 |
Last Update Date | 02/09/2011 |