Organization
EUSTRESS THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MUSTAFA MOYENDA LCPC, CAADC (COO)
(872) 221-0041
Entity
Organization
Contact information
Practice address
9510 S CONSTANCE AVE, SUITE C-6, CHICAGO, IL 60617-4700
(872) 221-0041
(866) 683-7047
Mailing address
4655 S LAKE PARK AVE, # 024, CHICAGO, IL 60653-4532
(872) 221-0041
(866) 683-7047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14823
IL
101YP2500X
Professional Counselor
Primary
180-003124
IL
225700000X
Massage Therapist
227013113
IL
Other
Enumeration date
04/01/2013
Last updated
08/19/2013
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