Individual
AMY TEVAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
303 E WACKER DR STE 1130, CHICAGO, IL 60601-5227
(312) 600-3935
Mailing address
303 E WACKER DR, CHICAGO, IL 60601-5212
(312) 600-3935
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.019198
IL
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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