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General NPI Number Information
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NPI Number | 1194315796
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Entity Type | Organization
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Legal Business Name | GOLDIELOCKS ZONE, INC.
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 1 FAIRLANE DR
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City | JOLIET
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State | IL
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Zip | 60435-5273
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Country | US
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Telephone | 708-288-7130
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Fax |
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Provider Business Mailing Address
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Address Line | 9898 FOREST ST
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City | DYER
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State | IN
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Zip | 46311-2895
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Country | US
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Telephone | 708-288-7130
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DAWN L THIELEMANN-SHIELDS
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Credential | LCPC
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Telephone | 708-288-7130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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