Individual
CESIAH BANUELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
3600 W FULLERTON AVE, CHICAGO, IL 60647-2319
(773) 782-2800
(773) 772-9105
Mailing address
5006 N HERMITAGE AVE APT 1E, CHICAGO, IL 60640-2733
(773) 310-0248
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180008957
IL
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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