Individual
EARLE RONALD KELWYN GROSVENOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
3420 W PETERSON AVE, SUITE 6, CHICAGO, IL 60659-3418
(312) 527-1290
(773) 267-6113
Mailing address
3420 W PETERSON AVE, SUITE 6, CHICAGO, IL 60659-3418
(312) 527-1290
(773) 267-6113
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.005976
IL
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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