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General NPI Number Information
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NPI Number | 1992055727
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Entity Type | Individual
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Provider Name | ANIETRA P LABRANCHE-O'NEAL PSY. D.
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Gender | Female
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 7600 S PARNELL AVE
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City | CHICAGO
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State | IL
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Zip | 60620-1824
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Country | US
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Telephone | 773-783-0500
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Fax | 773-783-0600
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Provider Business Mailing Address
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Address Line | 2601 LINCOLN HWY SUITE 101
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1862
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Country | US
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Telephone | 773-364-6143
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178003532
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License Number State | IL
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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