OTHELLA BANNER

CHICAGO, IL
NPI1386083665
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
(Licence: IL  101y00000X)
Enumeration Date2013-06-19
Last Update Date2013-06-19
Business Address
Mrs. OTHELLA BANNER LCPC
641 W 63RD ST
CHICAGO, IL 60621-2032
Phone number: 312-747-7496
Mailing Address
Mrs. OTHELLA BANNER LCPC
641 W 63RD ST
CHICAGO, IL 60621-2032
Phone number: 312-747-7496
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