Individual
MS. JEAN TOLAR THREATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, BCPC
Contact information
Practice address
627 E 100TH ST, CHICAGO, IL 60628-2260
(773) 918-6100
(773) 778-9235
Mailing address
627 E 100TH ST, CHICAGO, IL 60628-2260
(773) 918-6100
(773) 778-9235
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180001683
IL
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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