Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 180.007629 | IL |
NPI | 1285923797 |
---|---|
Provider Name | Ms. Annette M Nigro |
First Address | Crest Hill, IL 60403-3153 |
Second Address | Crest Hill, IL 60403-3153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2011 |
Last Update Date | 11/04/2011 |