Individual
HEATHER RAE HOLLYSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, MS
Contact information
Practice address
3354 N PAULINA ST STE 205, CHICAGO, IL 60657-1087
(224) 372-3963
Mailing address
4037 N MAPLEWOOD AVE, CHICAGO, IL 60618-3717
(708) 307-4583
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166001457
IL
106H00000X
Marriage & Family Therapist
208000658
IL
Other
Enumeration date
08/21/2018
Last updated
03/24/2021
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