Doctor Name: | ANNA DZIEKONSKI |
NPI Number: | 1093107344 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 180009550 |
Business Practice Address: | 3436 N Kennicott Ave Arlington Hts, IL - 600047814 |
Business Phone Number: | 8479527460 |
Business Fax Number: | 8472221754 |
Mailing Address: | 3436 N Kennicott Ave, ARLINGTON HTS |
State: | IL |
Postal Code: | 600047814 |
Phone Number: | 8479527460 |
Fax Number: | 8472221754 |
NPI Enumeration Date: | 02/24/2015 |
NPI Last Update Date: | 02/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 180009550 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |