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General NPI Number Information
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NPI Number | 1346854478
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Entity Type | Organization
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Legal Business Name | KANDEE'S INTIMACY & SEX COUNSELING & THERAPY SERVICES LLC
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Dates
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Enumeration Date | 09/05/2020
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Last Update Date | 09/05/2020
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Provider Practice Location Address
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Address Line | 477 E BUTTERFIELD RD STE 310
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City | LOMBARD
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State | IL
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Zip | 60148-4880
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Country | US
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Telephone | 630-273-1093
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Fax |
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Provider Business Mailing Address
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Address Line | 409 TRENTON CT
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City | AURORA
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State | IL
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Zip | 60504-2009
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Country | US
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Telephone | 630-273-1093
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KANDEE WILLIS
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Credential | LCPC
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Telephone | 630-273-1093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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