Individual
MISS AMAINAVT VIXAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 W IRVING PARK RD UNIT E4, CHICAGO, IL 60618-3360
(630) 822-4718
Mailing address
3300 W IRVING PARK RD UNIT E4, CHICAGO, IL 60618-3360
(630) 822-4718
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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