Individual
BRANDON DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15303 S 94TH AVE STE 250, ORLAND PARK, IL 60462-3825
(888) 428-7890
Mailing address
15303 S 94TH AVE STE 250, ORLAND PARK, IL 60462-3825
(888) 428-7890
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/30/2017
Last updated
02/13/2023
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