Individual
BREANNA LYNN VANDEN BOOGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6713 KINGERY HWY, WILLOWBROOK, IL 60527-5142
(773) 234-0423
Mailing address
9659 BRYAN PL, CROWN POINT, IN 46307-7472
(708) 822-2467
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.015433
IL
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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