Individual
BREON ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1427 W FARWELL AVE, 3S, CHICAGO, IL 60626-3426
(517) 944-5250
Mailing address
1427 W FARWELL AVE, 3S, CHICAGO, IL 60626-3426
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.012335
IL
Other
Enumeration date
05/07/2017
Last updated
05/07/2017
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