Individual
ANITA KOENITZ-HUDAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
929 EDGEWOOD RD, HIGHLAND PARK, IL 60035-4623
(224) 765-3214
(224) 765-3214
Mailing address
929 EDGEWOOD RD, HIGHLAND PARK, IL 60035-4623
(224) 765-3214
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16213556
—
IL
Enumeration date
01/02/2018
Last updated
01/02/2018
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