Individual
JACQUELYN HERNANDEZ CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSMFT
Contact information
Practice address
316 WESLEY AVE, EVANSTON, IL 60202-3235
(847) 219-2842
Mailing address
316 WESLEY AVE, EVANSTON, IL 60202-3235
(847) 219-2842
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
IL
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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