Organization
PANOZZO THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ANN PANOZZO LCSW (LICENSE CLINICAL SOCIAL WORKER)
(708) 846-2869
Entity
Organization
Contact information
Practice address
15915 S CRYSTAL CREEK DR, UNIT E, HOMER GLEN, IL 60491-9284
(708) 846-2869
(708) 349-1464
Mailing address
PO BOX 2351, ORLAND PARK, IL 60462-1030
(708) 846-2869
(708) 349-1464
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149.012262
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216914
PTAN
IL
Enumeration date
04/23/2014
Last updated
04/23/2014
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