Individual provider · Type 1 NPI

De'shace Short

Professional Counselor · Rockford, IL

NPI number 1386429686 Active

Practice location

5758 Elaine Dr Ste 112
Rockford, IL 61108-3102

Call (815) 975-1177 Map

Mailing address

9840 S Genoa Ave
Chicago, IL 60643-1537

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1386429686

De'shace Short's National Provider Identifier is 1386429686, issued on Aug 28, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Rockford, IL. The record was last updated on Aug 28, 2023.