Individual
AMMETH LISSET VALLINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 RIDGE AVE # G320, EVANSTON, IL 60201-2716
(847) 644-2054
Mailing address
2100 RIDGE AVE # G320, EVANSTON, IL 60201-2716
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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