Individual
MS. LENETTE BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2615 WASHINGTON ST, WAUKEGAN, IL 60085-4980
(855) 990-1900
Mailing address
1147 SAWMILL LN, ALGONQUIN, IL 60102-5967
(708) 769-2759
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209025267
IL
Other
Enumeration date
08/04/2022
Last updated
12/15/2022
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