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General NPI Number Information
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NPI Number | 1558052035
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Entity Type | Organization
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Legal Business Name | IMPERFECT HARMONY COUNSELING LTD
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 495 N RIVERSIDE DR STE 104
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City | GURNEE
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State | IL
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Zip | 60031-5919
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Country | US
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Telephone | 847-650-2660
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E COOK AVE APT 104
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-2038
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Country | US
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Telephone | 847-650-2660
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CLAUDIA TALIA
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Credential | LCPC
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Telephone | 847-650-2660
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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 |
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License Number State |
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