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General NPI Number Information
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NPI Number | 1841983988
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Entity Type | Organization
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Legal Business Name | SOUL THERAPY INC
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 15 BEECHNUT DR
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City | SOUTH BARRINGTON
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State | IL
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Zip | 60010-9514
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Country | US
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Telephone | 773-232-1815
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Fax |
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Provider Business Mailing Address
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Address Line | 6510 N LINCOLN AVE
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-3919
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Country | US
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Telephone | 773-232-1815
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. NISHAT SHAMS ALI
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Credential | DR
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Telephone | 773-232-1815
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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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