Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 37AC00522600 | NJ |
NPI | 1992325518 |
---|---|
Provider Name | Claudia Chavez |
First Address | Vernon Hills, IL 60061-1454 |
Second Address | Lyndhurst, NJ 07071-3615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2020 |
Last Update Date | 23/04/2020 |