Individual provider · Type 1 NPI

Suriyya Azra Maryum Latif

Mental Health Counselor · Waukegan, IL

NPI number 1265117451 Active

Practice location

3002 Grand Ave
Waukegan, IL 60085-2321

Call (847) 377-8618 Map

Fax (847) 984-5676

Specialties and licenses

TaxonomyCodeLicense
Case Management Agency 251B00000XNone listed
Substance Abuse Rehabilitation Facility 324500000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1265117451

Suriyya Azra Maryum Latif's National Provider Identifier is 1265117451, issued on Jun 16, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Waukegan, IL. The record was last updated on Nov 21, 2023.