Individual
JANINE MARIE PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1010 LAKE ST STE 500, OAK PARK, IL 60301-1135
(773) 665-8052
Mailing address
1020 W LAWRENCE AVE APT 531, CHICAGO, IL 60640-5007
(616) 821-4241
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.015014
IL
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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