Individual
ESTELA MELGOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, PHD
Contact information
Practice address
966 W 21ST ST, CHICAGO, IL 60608
(733) 254-1400
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(733) 254-1400
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.010589
IL
Other
Enumeration date
07/31/2017
Last updated
05/22/2018
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