Individual
MS. MARY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
5210 MAIN ST, SKOKIE, IL 60077-2158
(847) 425-7503
Mailing address
5210 MAIN ST, SKOKIE, IL 60077-2158
(847) 425-7503
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
IL
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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