Individual
BRIGID MOIRE KELLY DAGENFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5419 W LAWRENCE AVE, CHICAGO, IL 60630-3686
(312) 869-9899
Mailing address
5615 W GIDDINGS ST, CHICAGO, IL 60630-3213
(614) 580-7349
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178011182
IL
101YP2500X
Professional Counselor
Primary
180010908
IL
Other
Enumeration date
04/12/2018
Last updated
08/29/2024
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