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Organization

KIMBERLY M ROTHWELL

Active
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Organization

KIMBERLY M ROTHWELL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY ROTHWELL M.A. BC-DMT, LCPC (DANCE/MOVEMENT THERAPIST)
(312) 968-3154
Entity
Organization

Contact information

Practice address
460 N MAIN ST, SUITE 302, GLEN ELLYN, IL 60137-5176
(312) 968-3154
Mailing address
838 HILL AVE, GLEN ELLYN, IL 60137-5207

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
28374
101YP2500X
Professional Counselor
Primary
180.007496
IL

Other

Enumeration date
10/15/2013
Last updated
02/07/2017
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