Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 180.004907 | IL |
NPI | 1003110214 |
---|---|
Provider Name | Ms. Michele Rene Arthur |
First Address | Alsip, IL 60803-1925 |
Second Address | Matteson, IL 60443-2404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2011 |
Last Update Date | 03/01/2011 |