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General NPI Number Information
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NPI Number | 1235873845
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Entity Type | Organization
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Legal Business Name | EARLY CHILDHOOD CONSULTING , INC
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 199 KEY LARGO DR
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City | ROMEOVILLE
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State | IL
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Zip | 60446-4145
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Country | US
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Telephone | 708-595-7498
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Fax |
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Provider Business Mailing Address
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Address Line | 199 KEY LARGO DR
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City | ROMEOVILLE
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State | IL
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Zip | 60446-4145
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Country | US
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Telephone | 708-595-7498
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | LYNETTE DE DIOS
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Credential |
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Telephone | 708-595-7498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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