Individual provider · Type 1 NPI
Walter Fasken
Addiction (Substance Use Disorder) Counselor · La Salle, IL
NPI number
1003538950
Active
Practice location
111 Bucklin St Ste 1
La Salle, IL 61301-2382
Mailing address
7648 S Oconto Ave
Bridgeview, IL 60455-1323
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 36350 (IL) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
2 other providers at this address
Other addiction (substance use disorder) counselor providers in La Salle
About NPI 1003538950
Walter Fasken's National Provider Identifier is 1003538950, issued on Sep 16, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in La Salle, IL. The record was last updated on Nov 4, 2022.