Individual
DIVINE BRABOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3704 BRIAR LN, HAZEL CREST, IL 60429-2414
(773) 563-7670
Mailing address
3704 BRIAR LN, HAZEL CREST, IL 60429-2414
(773) 563-7670
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178013828
IL
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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