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Individual
KIMBERLY M ANTOS-HOGAN
Active
Individual
KIMBERLY M ANTOS-HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LCPC, CRC,
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180000743
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00007720
CERTIFIED REHABILITATION COUNSELOR
IL
01
—
15655
BOARD CERTIFIED PROFESSIONAL COUNSELOR
IL
01
—
180000743
COUNSELOR
IL
Enumeration date
01/11/2018
Last updated
01/11/2018
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