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Individual

MS. AMANIE SALAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
715 LAKE ST, OAK PARK, IL 60301-1422
(773) 312-3612
Mailing address
9213 WALNUT LN, TINLEY PARK, IL 60487-5256
(708) 502-4173

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
248001003
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
248001003
IL
Enumeration date
06/11/2022
Last updated
06/11/2022
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