Individual
KYLENE HENTHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3504 COMMERCIAL AVE, NORTHBROOK, IL 60062-1821
(847) 272-5111
Mailing address
3504 COMMERCIAL AVE, NORTHBROOK, IL 60062-1821
(847) 272-5111
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178012976
IL
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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