Individual
MRS. GLORIA E PASSALACQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LCPC
Contact information
Practice address
6551 W NORTH AVE, OAK PARK, IL 60302
(847) 687-4848
(847) 853-0069
Mailing address
500 KOERPER CT, WILMETTE, IL 60091
(847) 853-0069
(847) 853-0069
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180-002124
IL
Other
Enumeration date
01/31/2007
Last updated
08/02/2011
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