Organization
ASCEND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE B ERICKSON (OFFICE MANAGER)
(708) 597-3065
Entity
Organization
Contact information
Practice address
12641 S VINCENNES RD, BLUE ISLAND, IL 60406
(708) 597-3065
(866) 883-9952
Mailing address
12641 S VINCENNES, BLUE ISLAND, IL 60406
(708) 597-3065
(866) 883-9952
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
10/06/2006
Last updated
08/22/2020
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