Individual
JASMINE BANNER - HUBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
800 E 55TH ST, CHICAGO, IL 60615-4906
(708) 724-9631
Mailing address
800 E 55TH ST, CHICAGO, IL 60615-4906
(708) 724-9631
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180010414
IL
Other
Enumeration date
09/21/2016
Last updated
02/13/2017
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