Joe Roberson Mardis LCPC

NPI 1346307675 - Counselor - 101YP2500X

NPI Details
NPI 1346307675
Gender Male
Enumeration Date 01/03/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1725 187TH ST
HOMEWOOD IL, 60430-3853, US
Phone (708) 906-8816
Fax (708) 922-0907
Business Location
1725 187TH ST
HOMEWOOD IL, 60430-3853, US
Phone (708) 906-8816
Fax (708) 922-0907
Toxanomy
Taxonomy Code 101YP2500X
License State Illinois
License Number 180-002029
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According to our database, Mr. Joe Roberson Mardis LCPC NPI is 1346307675, taxonomy code is 101YP2500X and license number is 180-002029, license state is located at Illinois. Joe Roberson Mardis LCPC physically located at 1725 187th St, Homewood IL, 60430-3853. NPI Number Joe Roberson Mardis LCPC has the Individual type.

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1346307675 NPI number is provided on an as is basis without warranty of any kind. 1346307675 is maintained by the National Plan & Provider Enumeration System. The contents of Joe Roberson Mardis LCPC are for informational purposes only.