Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 149.002888 | IL |
NPI | 1003111329 |
---|---|
Provider Name | Ms. Linda Tandet |
First Address | Long Grove, IL 60047-9563 |
Second Address | Long Grove, IL 60047-9563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2011 |
Last Update Date | 18/01/2011 |