Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 178.015505 | IL |
NPI | 1003454331 |
---|---|
Provider Name | Sania Fatima Hussain |
First Address | Chicago, IL 60625-3125 |
Second Address | Chicago, IL 60659-3317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2019 |
Last Update Date | 17/12/2019 |