Individual
DR. CAROLYN SUZETTE CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDD CADC THD
Contact information
Practice address
2215 W 95TH ST, CHICAGO, IL 60643-1001
(773) 819-0646
Mailing address
9105 S HARPER AVE, CHICAGO, IL 60619-7917
(773) 550-5591
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
20997
IL
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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