Doctor Name: | MS. COLLEEN MARIE MCNALLY |
NPI Number: | 1225186968 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., L.C.P.C., |
License Number: | 180-003590 |
Business Practice Address: | 8020 W 87th St Hickory Hills, IL - 604571189 |
Business Phone Number: | 7087414500 |
Business Fax Number: | 7087414501 |
Mailing Address: | 5205 Ellington Ave, WESTERN SPRINGS |
State: | IL |
Postal Code: | 605582036 |
Phone Number: | 7087849967 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 180-003590 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |