Individual
MICA COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5800 ALLEMONG DR, MATTESON, IL 60443-1108
(708) 674-9417
Mailing address
5800 ALLEMONG DR, MATTESON, IL 60443-1108
(708) 674-9417
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178010374
IL
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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