Individual
JAMIE KMIECIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4745 MAIN ST STE 207, LISLE, IL 60532-1758
(630) 442-1895
Mailing address
4285 WHITE BIRCH DR, LISLE, IL 60532-1252
(630) 244-9682
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.020146
IL
Other
Enumeration date
05/04/2024
Last updated
05/04/2024
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