Doctor Name: | JILL VENAY SAMONTE |
NPI Number: | 1285935544 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | 180-002913 |
Business Practice Address: | 300 E 5th Ave Prairie Family Therapy Naperville, IL - 605633177 |
Business Phone Number: | 6305798070 |
Business Fax Number: | |
Mailing Address: | 300 E 5th Ave, Prairie Family Therapy NAPERVILLE |
State: | IL |
Postal Code: | 605633177 |
Phone Number: | 6305798070 |
Fax Number: | |
NPI Enumeration Date: | 11/03/2010 |
NPI Last Update Date: | 11/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180-002913 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |