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Individual

PAMELA ELLEN VANCOLLINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LMSW, LPN, QMHP

Contact information

Practice address
7338 S DANTE AVE, CHICAGO, IL 60619-2117
(773) 983-6066
Mailing address
7338 S DANTE AVE, CHICAGO, IL 60619-2117
(773) 983-6066

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
104100000X
Social Worker
Primary
IL
164W00000X
Licensed Practical Nurse
43053264
IL

Other

Enumeration date
05/20/2022
Last updated
05/20/2022
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