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Individual

MICHAEL SOUCIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
25259 S REED ST, CHANNAHON, IL 60410-6003
(815) 467-0555
Mailing address
3301 DEER ST APT 1C, WOODRIDGE, IL 60517-3246

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
IL
101Y00000X
Counselor
Primary
1041C0700X
Clinical Social Worker
149025186
IL

Other

Enumeration date
12/29/2022
Last updated
05/04/2023
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