| Center For Grief And Traumatic Loss, Llc | |
|
1144 Harms Ave Libertyville IL 60048-2524 | |
| (847) 680-0279 | |
| Not Available |
| Full Name | Center For Grief And Traumatic Loss, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1144 Harms Ave, Libertyville, Illinois |
| Authorized Official Name and Position | Allan L. Botkin (DIRECTOR) |
| Authorized Official Contact | 8476800279 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Grief And Traumatic Loss, Llc 1144 Harms Ave Libertyville IL 60048-2524 Ph: (847) 680-0279 | Center For Grief And Traumatic Loss, Llc 1144 Harms Ave Libertyville IL 60048-2524 Ph: (847) 680-0279 |
| NPI Number | 1366655813 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366655813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (Illinois) | Primary |
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