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General NPI Number Information
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NPI Number | 1750722013
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Entity Type | Organization
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Legal Business Name | PATTON AND ASSOCIATES
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 29W522 BATAVIA RD
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City | WARRENVILLE
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State | IL
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Zip | 60555-2007
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Country | US
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Telephone | 309-269-7982
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Fax |
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Provider Business Mailing Address
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Address Line | 29W522 BATAVIA RD
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City | WARRENVILLE
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State | IL
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Zip | 60555-2007
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Country | US
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Telephone | 309-269-7982
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Fax |
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Authorized Official
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Title or Position | FAMILY THERAPIST
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Name | GAY L PATTON
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Credential | LMFT, LPC
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Telephone | 309-269-7982
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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 | 178.005684
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166.000853
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License Number State | IL
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