| Doctor Name: | MRS. DANETTE TIARRIZZO PALOMAR |
| NPI Number: | 1285968115 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 180-004387 |
| Business Practice Address: | 444 Greenbay Road Kenilworth, IL - 60043 |
| Business Phone Number: | 8478530234 |
| Business Fax Number: | 8478530230 |
| Mailing Address: | 2742 W Wellington Ave, CHICAGO |
| State: | IL |
| Postal Code: | 606187823 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2009 |
| NPI Last Update Date: | 09/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 180-004387 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |