Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 180.011125 | IL |
NPI | 1003321290 |
---|---|
Provider Name | Kaitlyn Rinke |
First Address | Joliet, IL 60431-8483 |
Second Address | Ottawa, IL 61350-1040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2017 |
Last Update Date | 10/12/2017 |