Individual
CARLY MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2755 N PINE GROVE AVE, CHICAGO, IL 60614-6109
(266) 531-2259
Mailing address
2053 N 86TH ST, WAUWATOSA, WI 53226-2744
(414) 239-0534
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178020366
IL
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/08/2023
Last updated
07/09/2024
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