| Doctor Name: | JANE A LOU |
| NPI Number: | 1326334467 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 180.007871 |
| Business Practice Address: | 100 Village Grn Lincolnshire, IL - 600693094 |
| Business Phone Number: | 8474155077 |
| Business Fax Number: | |
| Mailing Address: | 1128 Garfield Ave, LIBERTYVILLE |
| State: | IL |
| Postal Code: | 600483612 |
| Phone Number: | 8479778517 |
| Fax Number: | 8472817247 |
| NPI Enumeration Date: | 06/28/2011 |
| NPI Last Update Date: | 06/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 180.007871 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |