Individual
JENNIFER ANN MORANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 DAKOTA ST, CRYSTAL LAKE, IL 60012-3742
(847) 354-5735
Mailing address
600 DAKOTA ST, CRYSTAL LAKE, IL 60012-3742
(847) 354-5735
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180006193
IL
Other
Enumeration date
10/02/2019
Last updated
07/31/2020
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