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Individual

BRENNA ROSE FRAYN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
1361 E LINCOLN HWY, NEW LENOX, IL 60451-2153
(815) 462-4273
Mailing address
862 N HERMITAGE AVE APT 1F, CHICAGO, IL 60622-5402
(708) 560-6980

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.013347
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
178.013347
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
10/22/2018
Last updated
10/22/2018
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