Individual
MS. ELIZABETH J MUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, RDT-BCT
Contact information
Practice address
1702 SHERMAN AVE, EVANSTON, IL 60201-3713
(847) 425-8336
Mailing address
1835 N HERMITAGE AVE, 1F, CHICAGO, IL 60622-1198
(773) 597-5303
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.007103
IL
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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