Individual
AMY BAZELON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
839 MOSELEY RD, HIGHLAND PARK, IL 60035-4635
(847) 707-5424
Mailing address
839 MOSELEY RD, HIGHLAND PARK, IL 60035-4635
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.010546
IL
Other
Enumeration date
10/22/2013
Last updated
10/27/2021
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