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General NPI Number Information
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NPI Number | 1447996087
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Entity Type | Organization
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Legal Business Name | B.U.B. PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 05/06/2022
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Provider Practice Location Address
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Address Line | 2329 N LAWNDALE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-2309
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Country | US
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Telephone | 312-399-1319
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Fax |
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Provider Business Mailing Address
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Address Line | 2329 N LAWNDALE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-2309
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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 | PSYCHOTHERAPIST AND OWNER
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Name | CINDY INIGUEZ
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Credential |
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Telephone | 312-399-1319
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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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