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General NPI Number Information
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NPI Number | 1609374669
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Entity Type | Individual
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Provider Name | DANA LAUGHLIN ED. D
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Gender | Female
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 10540 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-2536
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Country | US
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Telephone | 708-527-0085
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Fax | 888-252-3267
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Provider Business Mailing Address
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Address Line | 10102 S GREEN ST
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City | CHICAGO
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State | IL
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Zip | 60643-2217
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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 |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 178008619
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License Number State | IL
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