Individual
AUDREY GOTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
405 CENTRAL AVE, NORTHFIELD, IL 60093-3006
(847) 441-5600
Mailing address
405 CENTRAL AVE, NORTHFIELD, IL 60093-3006
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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