Organization
LILY THERAPY & WELLNESS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE FERRERIA-FONG LCPC (PRESIDENT)
(904) 415-2919
Entity
Organization
Contact information
Practice address
5614 N MULLIGAN AVE, CHICAGO, IL 60646-6129
(312) 884-9041
Mailing address
5614 N MULLIGAN AVE, CHICAGO, IL 60646-6129
(312) 884-9041
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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