Individual
MRS. MYRA CLEMENTINE CASTANEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
5100 N RAVENSWOOD AVE STE 209, CHICAGO, IL 60640-1710
(773) 769-7204
Mailing address
5011 N CALIFORNIA AVE APT 2, CHICAGO, IL 60625-3617
(773) 656-2504
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166.001321
IL
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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