Individual
TANYA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
612 BELLWOOD AVE, BELLWOOD, IL 60104-1823
(708) 510-0567
Mailing address
612 BELLWOOD AVE, BELLWOOD, IL 60104-1823
(708) 510-0567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
31039
IL
Other
Enumeration date
11/14/2024
Last updated
11/14/2024
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