Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor |
NPI | 1134692122 |
---|---|
Provider Name | Katya Michelle Riccio |
First Address | Aurora, IL 60506-3462 |
Second Address | Aurora, IL 60506-3462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2019 |
Last Update Date | 02/01/2019 |