Individual
MISS ODESSA P CONORQUIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
1357 W MAPLE AVE APT 315, MUNDELEIN, IL 60060-1491
(773) 972-1261
Mailing address
1357 W MAPLE AVE., APT 315, MUNDELEIN, IL 60060
(773) 972-1261
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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