Individual
MS. GINA M STATEN BRABHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
1023 BURLINGTON AVE., WESTERN SPRINGS, IL 60558
(708) 354-0826
(708) 354-0867
Mailing address
7003 SIERRA CT., DARIEN, IL 60561
(708) 354-0826
(708) 354-0867
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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