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NPI Code Detail

MEDICARE: MISS RAVEN GEORGETTE CURLING MA, LPC

MEDICARE:  MISS RAVEN GEORGETTE CURLING  MA, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor178011943IL

General Provider Information

NPI Number : 1558801274
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS RAVEN GEORGETTE CURLING MA, LPC
Provider Business Mailing Address
First Line : 10330 S GREEN ST
Second Line :
City : CHICAGO
State : IL
Zip : 60643-3012
Country : US
Telephone Number : 312-714-5279
Fax Number :
Provider Business Practice Location Address
First Line : 1032 W SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60660-1537
Country : US
Telephone Number : 312-915-8844
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2017
Last Update Date : 02/28/2017

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Directions to “ MISS RAVEN GEORGETTE CURLING MA, LPC” Practice Location

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