Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 178005277 | IL |
N | 101YP2500X | Professional Counselor | 178005277 | IL |
NPI | 1164769832 |
---|---|
Provider Name | Katherine Koester |
First Address | Skokie, IL 60077-2269 |
Second Address | Skokie, IL 60077-2269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2013 |
Last Update Date | 05/01/2018 |