Individual
DEVIN CISNEROS GARCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4725 N LARAMIE AVE, CHICAGO, IL 60630-3607
(312) 375-4664
Mailing address
721 N LA SALLE DR, CHICAGO, IL 60654-3751
(312) 948-6993
(217) 782-3991
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156951360
—
IL
Enumeration date
07/14/2022
Last updated
07/14/2022
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