Individual
ADA LOUISE KENTRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
915 LAURA LN, SAUK VILLAGE, IL 60411-5097
(708) 733-3671
Mailing address
4331 LINCOLN HWY, MATTESON, IL 60443-2404
(708) 748-1951
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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