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Individual
THERESA LATISHA WATERS
Active
Individual
THERESA LATISHA WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
150.112384
IL
Other
Enumeration date
08/11/2023
Last updated
12/10/2025
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