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General NPI Number Information
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NPI Number | 1093317109
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Entity Type | Individual
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Provider Name | JENILLE GUNTER-HARLAN MS
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Gender | Female
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Dates
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Enumeration Date | 11/13/2020
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 190 LILY CACHE LN
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City | BOLINGBROOK
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State | IL
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Zip | 60440-3415
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Country | US
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Telephone | 630-286-9770
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Fax |
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Provider Business Mailing Address
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Address Line | 445 ROCKHURST RD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-2462
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Country | US
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Telephone | 630-461-6524
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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