Organization
MOSAIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KENDRA BOSTICK LCSW (MENTAL HEALTH COUNSELOR)
(734) 660-6338
Entity
Organization
Contact information
Practice address
801 SKOKIE BLVD STE 106, NORTHBROOK, IL 60062-4026
(734) 660-6338
Mailing address
1330 N MILWAUKEE AVE, CHICAGO, IL 60622-8810
(734) 660-6338
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
955674
IL
Other
Enumeration date
06/24/2016
Last updated
06/24/2016
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