Individual
MERINDA STAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1909 CHEKER SQ, E HAZEL CREST, IL 60429-1442
(708) 647-3334
Mailing address
3419 KINGS RD APT 302, STEGER, IL 60475-1349
(708) 243-4068
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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