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1104878008
STACY MALM
CHICAGO, IL
NPI
1104878008
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: IL 180005923)
Enumeration Date
2006-05-17
Last Update Date
2007-11-29
Business Address
-- STACY MALM LCPC
3401 N CENTRAL AVE
CHICAGO, IL 60634-4426
Phone number: 773-286-8822
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Mailing Address
-- STACY MALM LCPC
3401 N CENTRAL AVE
CHICAGO, IL 60634-4426
Phone number: 773-286-8822
Copy
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