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1508204066
CHARLES S MIYAMOTO
EVANSTON, IL
NPI
1508204066
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 178.008311)
Enumeration Date
2013-06-06
Last Update Date
2013-10-21
Business Address
-- CHARLES S MIYAMOTO Rev.; LPC
1427 CHICAGO AVE
EVANSTON, IL 60201-4726
Phone number: 847-864-9133
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Mailing Address
-- CHARLES S MIYAMOTO Rev.; LPC
1427 CHICAGO AVE
EVANSTON, IL 60201-4726
Phone number: 847-864-9133
Copy
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