Individual
RUTH DIAB LEDERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3002 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8200
Mailing address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178006654
IL
101YM0800X
Mental Health Counselor
178006654
IL
101YP2500X
Professional Counselor
178006654
IL
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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