Individual
MISTURA ABIDEMI OLAWORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
655 W IRVING PARK RD, CHICAGO, IL 60613-3123
(773) 304-8723
Mailing address
5820 N KENMORE AVE APT 106, CHICAGO, IL 60660-3701
(847) 986-0981
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178017396
IL
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
178017396
IL
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
06/28/2021
Last updated
07/30/2024
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