Individual
JENNA ANN PRONGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 W 93RD ST, OAK LAWN, IL 60453-1998
(708) 423-0150
Mailing address
10360 S 84TH AVE, PALOS HILLS, IL 60465-1702
(708) 983-3101
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178.008085
LICENSED PROFESSIONAL COUNSELOR
IL
01
—
180.009347
LICENSED CLINICAL PROFESSIONAL COUNSELOR
IL
Enumeration date
01/04/2013
Last updated
09/24/2019
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