Individual
MS. GENAEA MARIE CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E 162ND ST, SOUTH HOLLAND, IL 60473
(773) 819-5504
(800) 220-1656
Mailing address
401 E 162ND ST, SOUTH HOLLAND, IL 60473-2236
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/01/2018
Last updated
08/07/2018
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