Individual
MRS. HOLLY DEROSA WALEJESKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
3139 N LINCOLN AVE STE 203, CHICAGO, IL 60657-3122
(773) 682-1988
Mailing address
3139 N LINCOLN AVE STE 203, CHICAGO, IL 60657-3122
(773) 682-1988
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180.007992
IL
101YP2500X
Professional Counselor
Primary
180.007992
IL
252Y00000X
Early Intervention Provider Agency
180.007992
IL
Other
Enumeration date
12/12/2007
Last updated
05/08/2013
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