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1508508417
KYLE PRESTON GOODWIN
DEKALB, IL
NPI
1508508417
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 180.014323)
Enumeration Date
2022-04-11
Last Update Date
2022-04-11
Business Address
Mr. KYLE PRESTON GOODWIN LCPC
1340 CHESTNUT ST
DEKALB, IL 60115-8971
Phone number: 773-947-4105
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Mailing Address
Mr. KYLE PRESTON GOODWIN LCPC
PO BOX 1104
DEKALB, IL 60115-7104
Phone number:
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