Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | IL |
NPI | 1003823519 |
---|---|
Provider Name | Mrs. Eileen H Glenn |
First Address | Evanston, IL 60201-3012 |
Second Address | Evanston, IL 60201-3840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/07/2007 |