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Organization
MARLYS A CONRAD PHD LLC
Active
Organization
MARLYS A CONRAD PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLYS A CONRAD PHD (OWNER)
(847) 624-7446
Entity
Organization
Contact information
Practice address
918 MICHIGAN AVE, APT 1, EVANSTON, IL 60202-1494
(847) 624-7446
Mailing address
918 MICHIGAN AVE, APT 1, EVANSTON, IL 60202-1494
(847) 624-7446
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
071003676
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071003676
ILLINOIS LICENSE
IL
Enumeration date
09/16/2015
Last updated
09/16/2015
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