Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 178013923 | IL |
N | 101YS0200X | School Counselor |
NPI | 1114401734 |
---|---|
Provider Name | Melanie Kohn |
First Address | Chicago, IL 60624-4310 |
Second Address | Chicago, IL 60624-4310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2018 |
Last Update Date | 19/09/2018 |