Individual
SUZANNE BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, CADC
Contact information
Practice address
11447 2ND ST STE 9B, ROSCOE, IL 61073-9522
(815) 601-4673
Mailing address
8180 FREEPORT RD, DURAND, IL 61024-9719
(815) 871-6381
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30760
IL
101YM0800X
Mental Health Counselor
150.014983
IL
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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