Individual provider · Type 1 NPI

Tracey Latonya Blackburn

Mental Health Counselor · Des Plaines, IL

NPI number 1629551304 Active

Practice location

1717 Rand Rd
Des Plaines, IL 60016-3509

Call (773) 294-5797 Map

Mailing address

1800 N Hermitage Ave
Chicago, IL 60622-1161

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1629551304

Tracey Latonya Blackburn's National Provider Identifier is 1629551304, issued on Sep 10, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Des Plaines, IL. The record was last updated on Sep 27, 2018.