Individual
ANITA JAMISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17064 SHEA AVE, HAZEL CREST, IL 60429-1351
(708) 955-4540
Mailing address
17064 SHEA AVE, HAZEL CREST, IL 60429-1351
(708) 955-4540
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12952
IL
101YP2500X
Professional Counselor
Primary
180.009241
IL
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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