Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 180008038 | IL |
N | 101YP2500X | Professional Counselor | 178006166 | IL |
N | 101YS0200X | School Counselor | 2348999 | IL |
NPI | 1154552420 |
---|---|
Provider Name | Michelle Shalin |
First Address | Northbrook, IL 60062-5907 |
Second Address | Northbrook, IL 60062-5907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 15/11/2011 |