Individual
CYNTHIA STAPLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 PARK ST, MANTENO, IL 60950-1030
(708) 821-8057
Mailing address
602 PARK ST, MANTENO, IL 60950-1030
(708) 821-8057
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.006236
IL
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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