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General NPI Number Information
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NPI Number | 1972344125
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Entity Type | Individual
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Provider Name | TABITHA YANNUZZI
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 53 W JACKSON BLVD STE 1615
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City | CHICAGO
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State | IL
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Zip | 60604-3722
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Country | US
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Telephone | 312-767-3704
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Fax |
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Provider Business Mailing Address
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Address Line | 10031 NORTHCOTE CT
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City | SAINT JOHN
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State | IN
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Zip | 46373-9503
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Country | US
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Telephone | 219-381-8766
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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 |
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License Number State | IL
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