Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 180.011030 | IL |
Y | 101YM0800X | Mental Health Counselor | 180.011030 | IL |
N | 101YP2500X | Professional Counselor | 180.011030 | IL |
N | 101YS0200X | School Counselor | 1899529 | IL |
NPI | 1235651464 |
---|---|
Provider Name | Mrs. Gabrielle Thibodeaux Abogado |
First Address | Naperville, IL 60565-2057 |
Second Address | Naperville, IL 60565-2057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2017 |
Last Update Date | 15/04/2020 |