Doctor Name: | KRISTINA CAPONI |
NPI Number: | 1699162412 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | 180007735 |
Business Practice Address: | 740 E Division St Coal City, IL - 604161337 |
Business Phone Number: | 3122522074 |
Business Fax Number: | |
Mailing Address: | 740 E Division St, COAL CITY |
State: | IL |
Postal Code: | 604161337 |
Phone Number: | 3122522074 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2015 |
NPI Last Update Date: | 07/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180007735 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |