Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225C00000X | Rehabilitation Counselor | ML22820803P | IL |
NPI | 1104953991 |
---|---|
Provider Name | Mrs. Mary Rubenacker Langan |
First Address | Aurora, IL 60506-4261 |
Second Address | Aurora, IL 60506-4261 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |