Individual provider · Type 1 NPI

Cory Nietzke

Professional Counselor · Chicago, IL

NPI number 1962832550 Active

Practice location

5547 N Ravenswood Ave
Chicago, IL 60640-1125

Fax (773) 769-1476

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X0178.005724 (IL)

Professional Counselor: Definition to come...

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About NPI 1962832550

Cory Nietzke's National Provider Identifier is 1962832550, issued on Nov 18, 2013. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Chicago, IL. The record was last updated on Nov 18, 2013.