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General NPI Number Information
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NPI Number | 1457544819
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Entity Type | Individual
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Provider Name | MS. DAUN DENISE BLAIN
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Gender | Female
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 135 N GREENLEAF ST 228
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City | GURNEE
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State | IL
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Zip | 60031-3393
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Country | US
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Telephone | 224-433-9932
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Fax | 847-548-8083
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Provider Business Mailing Address
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Address Line | 135 N GREENLEAF ST STE 228
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City | GURNEE
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State | IL
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Zip | 60031-3371
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Country | US
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Telephone | 224-433-9932
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.000167
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License Number State | IL
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