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General NPI Number Information
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NPI Number | 1699334037
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Entity Type | Individual
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Provider Name | PATRICIA RAE AHERN LPC
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Gender | Female
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Dates
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Enumeration Date | 06/10/2019
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 18154 MARTIN AVE STE 2
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City | HOMEWOOD
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State | IL
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Zip | 60430-2155
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Country | US
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Telephone | 708-929-8333
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Fax |
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Provider Business Mailing Address
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Address Line | 10635 S HAMILTON AVE
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City | CHICAGO
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State | IL
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Zip | 60643-3127
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Country | US
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Telephone | 773-445-3220
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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 |
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License Number State |
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