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General NPI Number Information
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NPI Number | 1396141313
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Entity Type | Organization
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Legal Business Name | MARRIAGE AND FAMILY SOLUTIONS LLC
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 290 SPRINGFIELD DR SUITE 140
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2214
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Country | US
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Telephone | 630-561-5849
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Fax |
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Provider Business Mailing Address
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Address Line | 290 SPRINGFIELD DR SUITE 140
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2214
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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 | OWNER/THERAPIST
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Name | ROBIN N HEFFERNAN
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Credential | LMFT, LCPC
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Telephone | 630-561-5849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166000630
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License Number State | IL
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