Organization
DAWN ZYWIEC PROFESSIONAL COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAWN MARIE ZYWIEC PHD, LCPC, RN (OWNER)
(309) 706-6445
Entity
Organization
Contact information
Practice address
2310 E OAKLAND AVE, SUITE 4, BLOOMINGTON, IL 61701-5865
(309) 706-6445
Mailing address
306 SPRING RIDGE DR, BLOOMINGTON, IL 61704-9072
(309) 706-6445
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
180004875
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902936636
NPI 1
IL
Enumeration date
03/06/2015
Last updated
03/06/2015
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