Organization
EPIPHANY LIFE COACH COUNSELING & RESOURCES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLLIS FERGUSON-COLLUM LCSW (COUNSELOR)
(773) 654-3875
Entity
Organization
Contact information
Practice address
15539 DOBSON AVE, DOLTON, IL 60419-2708
(773) 654-3875
Mailing address
15539 DOBSON AVE, DOLTON, IL 60419-2708
(773) 654-3875
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149015907
IL
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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