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Organization
TAGUA COUNSELING PLLC
Active
Organization
TAGUA COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BAUTISTA LCSW (LICENSED CLINICAL SOCIAL WORKER)
(773) 480-3412
Entity
Organization
Contact information
Practice address
917 W 18TH ST STE 222, CHICAGO, IL 60608-2400
(312) 841-9337
Mailing address
PO BOX 12454, CHICAGO, IL 60612-0454
(312) 841-9337
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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