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Individual

MRS. JALISSA REYNOLDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
9631 S CICERO AVE # 1073, OAK LAWN, IL 60453-3137
(708) 637-6760
Mailing address
631 N CARROLL PKWY APT 209, GLENWOOD, IL 60425-1161
(708) 637-6760

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
180014119
IL

Other

Enumeration date
02/17/2011
Last updated
05/07/2024
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