| Moving Mosaic Therapy & Counseling, Pllc | |
|
2232 S 18th Ave North Riverside IL 60546-1014 | |
| (773) 373-9682 | |
| (773) 312-4876 |
| Full Name | Moving Mosaic Therapy & Counseling, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2232 S 18th Ave, North Riverside, Illinois |
| Authorized Official Name and Position | Katie Marie Dominguez (CO-FOUNDER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 7733739682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moving Mosaic Therapy & Counseling, Pllc 2232 S 18th Ave North Riverside IL 60546-1014 Ph: (773) 373-9682 | Moving Mosaic Therapy & Counseling, Pllc 2232 S 18th Ave North Riverside IL 60546-1014 Ph: (773) 373-9682 |
| NPI Number | 1093474652 |
|---|---|
| Provider Enumeration Date | 12/10/2021 |
| Last Update Date | 10/02/2023 |
| Certification Date | 10/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093474652 | NPI | - | NPPES |
| 6839423 | Other | IL | AETNA PPO OUTPATIENT PROVIDER |
| 1407515919 | Other | IL | NPI |
| 1447804869 | Other | IL | NPPES |
| 1518427731 | Other | IL | NPI |
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