Individual
BRANDI GRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
145 S VIRGINIA ST, THE MATHERS CLINIC, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
Mailing address
145 S VIRGINIA ST, THE MATHERS CLINIC, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180010718
IL
101YP2500X
Professional Counselor
180010718
IL
Other
Enumeration date
03/23/2017
Last updated
04/06/2017
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