Individual
LETICIA AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHP
Contact information
Practice address
2619 CONGRESS ST, BELLWOOD, IL 60104-2405
(708) 234-8668
Mailing address
2619 CONGRESS ST, BELLWOOD, IL 60104-2405
(708) 234-8668
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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