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General NPI Number Information
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NPI Number | 1679106322
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Entity Type | Organization
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Legal Business Name | ASSOCIATION FOR INDIVIDUAL DEVELOPMENT
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 1230 N HIGHLAND AVE
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City | AURORA
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State | IL
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Zip | 60506-1401
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Country | US
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Telephone | 630-966-4301
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Fax | 630-859-2994
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Provider Business Mailing Address
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Address Line | 1230 N HIGHLAND AVE
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City | AURORA
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State | IL
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Zip | 60506-1401
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Country | US
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Telephone | 630-966-4301
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Fax | 630-859-2994
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Authorized Official
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Title or Position | REHABILITATIVE SERVICES ASSOCIATE
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Name | MRS. LISA DAWN SNYDER
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Credential | RSA
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Telephone | 630-966-4301
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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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