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General NPI Number Information
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NPI Number | 1700499704
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Entity Type | Individual
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Provider Name | GUADALUPE A VALENCIA
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Gender | Female
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 1531 S GROVE AVE UNIT 204
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City | BARRINGTON
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State | IL
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Zip | 60010-5251
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Country | US
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Telephone | 773-312-4437
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Fax |
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Provider Business Mailing Address
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Address Line | 1075 HIGGINS QUARTERS DR APT 108
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-1437
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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 | 178.016218
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License Number State | IL
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