Doctor Name: | MS. PATRICIA THEODORE |
NPI Number: | 1235574609 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CADC |
License Number: | |
Business Practice Address: | 101 S Jefferson St Woodstock, IL - 600983437 |
Business Phone Number: | 8153387360 |
Business Fax Number: | 8153375510 |
Mailing Address: | 101 S Jefferson St, WOODSTOCK |
State: | IL |
Postal Code: | 600983437 |
Phone Number: | 8153387360 |
Fax Number: | 8153375510 |
NPI Enumeration Date: | 04/30/2013 |
NPI Last Update Date: | 04/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |