Individual
TARA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-7415
Mailing address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-7415
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
IL
225C00000X
Rehabilitation Counselor
Primary
—
IL
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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