| Practical Audacity Llc | |
|
3530 W Palmer St Apt 2 Chicago IL 60647-3575 | |
| (318) 547-1823 | |
| Not Available |
| Full Name | Practical Audacity Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3530 W Palmer St Apt 2, Chicago, Illinois |
| Authorized Official Name and Position | Rena Mcdaniel (FOUNDER AND THERAPIST) |
| Authorized Official Contact | 3185471823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Practical Audacity Llc 3530 W Palmer St Apt 2 Chicago IL 60647-3575 Ph: (318) 547-1823 | Practical Audacity Llc 3530 W Palmer St Apt 2 Chicago IL 60647-3575 Ph: (318) 547-1823 |
| NPI Number | 1407361314 |
|---|---|
| Provider Enumeration Date | 12/14/2017 |
| Last Update Date | 12/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407361314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180.010161 (Illinois) | Primary |
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