Individual
BAKAHIA MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
400 W 76TH ST STE 324, CHICAGO, IL 60620-1640
(773) 673-7636
Mailing address
400 W 76TH ST STE 324, CHICAGO, IL 60620-1640
(773) 673-7636
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180010155
IL
Other
Enumeration date
01/26/2019
Last updated
01/26/2019
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