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Individual

MRS. JOAN M. BISTRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., N.C.C.A.

Contact information

Practice address
318 W CHIPPEWA ST, DWIGHT, IL 60420-1206
(815) 584-9312
Mailing address
318 W CHIPPEWA ST, DWIGHT, IL 60420-1206
(815) 584-9312

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YP1600X
Pastoral Counselor

Other

Enumeration date
08/01/2011
Last updated
08/01/2011
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