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General NPI Number Information
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NPI Number | 1386368462
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Entity Type | Organization
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Legal Business Name | HARMONIOUS HEALING
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 17 N WABASH AVE STE 515
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City | CHICAGO
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State | IL
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Zip | 60602-4818
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Country | US
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Telephone | 414-751-0225
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Fax |
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Provider Business Mailing Address
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Address Line | 1624 W ADDISON ST
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City | CHICAGO
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State | IL
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Zip | 60613-3616
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMIN ASSISTANT
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Name | ESTRELLA GONZALEZ
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Credential |
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Telephone | 312-685-1589
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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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