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General NPI Number Information
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NPI Number | 1740499466
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Entity Type | Individual
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Provider Name | DYANNE CYNTHIA BRESLER LCPC
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 36 MAIN ST 106B
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City | PARK RIDGE
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State | IL
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Zip | 60068-4059
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Country | US
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Telephone | 847-692-6692
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Fax | 888-440-2577
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Provider Business Mailing Address
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Address Line | 36 MAIN ST
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City | PARK RIDGE
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State | IL
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Zip | 60068-4059
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Country | US
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Telephone | 847-692-6692
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Fax | 888-440-2577
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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 | 180.006486
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License Number State | IL
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