Individual
OAK MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 W RIVER RD, ELGIN, IL 60123-1570
(847) 281-5394
Mailing address
349 WALNUT CIR, BOLINGBROOK, IL 60440-1979
(815) 991-0825
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
04/04/2023
Last updated
08/27/2024
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