Individual
MRS. ERICA ANN QUENSEN-DIEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCPC, ADTR
Contact information
Practice address
24402 W LOCKPORT RD, SUITE 2B, PLAINFIELD, IL 60544-4206
(630) 401-0264
(815) 254-3419
Mailing address
2208 COVINGTON CT, PLAINFIELD, IL 60586-5504
(630) 401-0264
(815) 254-3419
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009932406
BCBS PROVIDER NUMBER
IL
Enumeration date
01/24/2007
Last updated
07/08/2007
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