Doctor Name: | AMY L BUSHEY |
NPI Number: | 1376789602 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | 180.007021 |
Business Practice Address: | 1240 Bamburg Ct Hanover Park, IL - 601335243 |
Business Phone Number: | 8477313192 |
Business Fax Number: | |
Mailing Address: | 1240 Bamburg Ct, HANOVER PARK |
State: | IL |
Postal Code: | 601335243 |
Phone Number: | 8477313192 |
Fax Number: | |
NPI Enumeration Date: | 12/16/2008 |
NPI Last Update Date: | 03/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180.007021 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |